摘要
On June 25,1990,seven technicians from a radiation medicine department in Shanghai were accidently exposed to a50 Co gamma radiation source within a short duration at a large dose rate,causing 7 cases of bone marrow form of acute radiation sickness(ARS).This unfortunate large dose of irradiation incidence is called '6.25 radiation accident'.This article reports the clinical progress of this relatively homogenous external irradiation, doses,early management and therapeutic outcomes of the 7 cases of bone marrow form of ARS. Two cases of extremely severe degree bone marrow form of ARS received about ll￣12 Gy total body irradiation (TBI). The living duration of both patients was prolonged owing to semi-identical HLA of allogenous bone marrow transplantation (BMT). One of the patients lived 25 d and the other survived 9o d. The donor chromosome XX showed that BMT was fully engrafted and hematopoiesis was reconstructed in 'Wan'. The remaining 5 cases of severe and moderate degree bone marrow form of ARS received 5. 2 Gy,4.1 Gy,2.5 Gy,2.4 Gy and 2.0 Gy irradiation. As a result of appropriate treatment,these patients passed smoothly the four stages of the clinical course without macro-symptoms and signs at the critical stages, presented with no significant infection and hemorrhagic syndrome. No similar report has been presented in our country and other countries.The 5 cases of ARS were discharged from the hospital because of clinical convalescence.Differential therapeutic management including protective isolation is recommended,and the effect of antiradiation agents such as Estradiol benzoate and Chinese herbal medicines is evaluated. Selective use of antiinfectious antibiotics, whole blood and blood component transfusion,gamma globulin and fetal liver cell infusion when indicated are also discussed.Sorted out by Professor Mai Zhiguang (Division of Radiation Medicine, Second Military Medical University,Shanghai,200433)
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