医源性急性放射病的临床观察

Clinical observation of iatrogenic acute radiation sickness.

目的观察医源性急性放射病的临床特点和治疗经验，为事故性放射病的救治提供依据。方法观察１７例经大剂量照射预处理的ＰＢＳＣＴ患者外周血象、体温和症状。结果照后第８～１２天，ＷＢＣ均值＜１×１０９／Ｌ，未用Ｇ－ＣＳＦ者白细胞持续此低值至１３．３天，２９％的患者体温＞３８．５℃，经无菌处理和强有力的抗感染治疗，患者均能平稳渡过骨髓抑制期而不出现典型的急性放射病极期表现。结论回输自体外周血干细胞和应用Ｇ－ＣＳＦ以缩短骨髓重建时间，严格实行全环境保护和及时、联合、足量应用抗生素的原则是ＰＢＳＣＴ患者能够顺利渡过放射病极期。

bjective\ Clinical observation of acute radiation sickness (ARS) induced by medical treatment in order to accumulate clinical experience .Methods\ The changes of peripheral blood indexes,temperature and clinical symptoms of 17 cases who were irradiated with 6.0 7.2Gy X ray before peripheral blood stem cell transplantation (PBSCT) were observed.\ Results\ WBC counts began to decrease to below 1×109/L from 8th day after irradiation and maintained at this level for 4 days,or for 13.3 days if the patients did not receive G CSF treatment.29.4% of patients ran a temperature higher than 385 ℃.After total environment protection and vigorous antibiotic treatment,all patients could successfully pass through the period of bone marrow depression without typical critical phase of ARS.\ Conclusion\ Auto peripheral blood stem cell transplantation and G CSF treatment to reduce the time span for reconstruction of bone marrow,total environment protection and combined antibiotic treatment are the key point of sucessful treatment of PBSCT.