A case of acute radiation injury of right finger caused by 192Ir external irradiation
10.3760/cma.j.issn.0254-5098.2019.11.010
- VernacularTitle: 一例192 Ir源外照射致右手指急性放射损伤的临床综合处理
- Author:
Yuhan HOU
1
;
Yulong LIU
;
Youyou WANG
;
Huahui BIAN
;
Weibo CHEN
;
Hong DAI
;
Junchao FENG
;
Ran CUI
;
Ruihao WANG
;
Yun DU
;
Min WANG
;
Zhen YAO
Author Information
1. Emergency Center, Second Affiliated Hospital of Soochow University, Suzhou 215004, China
- Publication Type:Journal Article
- Keywords:
192Ir;
Acute radiation induced skin iniury;
Excessive external exposure
- From:
Chinese Journal of Radiological Medicine and Protection
2019;39(11):852-858
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the treatment technique, occurrence and development patterns of such radiation injuries as in a major radiological accident in which a victim suffered mild bone marrow radiation sickness combined grade degree Ⅲ acute radiation induced skin injury, based on his dose estimation, clinical manifestations and disease treatments.
Methods:History inquiry in detail, earlier physical dose estimation and biological dose estimation were conducted in conjunction with analyzing the chromosome aberration of peripheral blood lymphocytes. The physical dose was estimated by Monte Carlo method.The systematic laboratory and imaging examination was performed to evaluate the condition. The comprehensive analysis was conducted to determine the diagnosis and treatment plan.
Results:At 3d after the exposure, "Ren" felt mild pain and discomfortable on the skin of the right index finger. The body of the right hand index finger was covered with blister at 21 d after exposure.The estimation of biological dose was 0.43 Gy (95%CI: 0.31-0.58 Gy), and the physical dose was estimated to be 36-164 Gy for each part of the right hand finger. The hematopoietic system, immune system and endocrine system were normal. The liver function index value was transiently increased. The liver damage resulted from the use of antibiotic-induced combined with the patient′s past medical history and admission examination result, and the relevant antibiotics were discontinued. The liver function returned to normal after liver protection treatment. At 22 d after irradiation, a right finger incision and decompression surgery were performed. The stem cells were extracted and implanted into the right index finger. After 59 days of hospitalization, there was no obvious discomfort in the body, and the right index finger recovered well, as well as the pain significantly relieved, and the knuckle activity was basically normal.
Conclusions:The patient with excessive radiation and grade Ⅲ acute radiation skin injury was successfully treated, and local application of autologous adipose-derived stem cell transplantation achieved good result .
