电离辐射损伤与疾病的管理，第4部分：急性放射综合征

Management of ionizing radiation injuries and illnesses, part 4: acute radiation syndrome.

作者信息

Christensen Doran M, Iddins Carol J, Parrillo Steven J, Glassman Erik S, Goans Ronald E

机构信息

From the Radiation Emergency Assistance Center/Training Site (Drs Christensen, Iddins, and Goans) and the National Security and Emergency Management Programs (Mr Glassman) at the Oak Ridge Institute for Science and Education in Tennessee; the Division of Emergency Medicine at Einstein Medical Center Elkins Park and the Philadelphia University Disaster Medicine and Management Master's Program, both in Philadelphia, Pennsylvania (Dr Parrillo); and the MJW Corporation in Amherst, New York (Dr Goans).

出版信息

J Am Osteopath Assoc. 2014 Sep;114(9):702-11. doi: 10.7556/jaoa.2014.138.

DOI:10.7556/jaoa.2014.138

PMID:25170040

Abstract

To provide proper medical care for patients after a radiation incident, it is necessary to make the correct diagnosis in a timely manner and to ascertain the relative magnitude of the incident. The present article addresses the clinical diagnosis and management of high-dose radiation injuries and illnesses in the first 24 to 72 hours after a radiologic or nuclear incident. To evaluate the magnitude of a high-dose incident, it is important for the health physicist, physician, and radiobiologist to work together and to assess many variables, including medical history and physical examination results; the timing of prodromal signs and symptoms (eg, nausea, vomiting, diarrhea, transient incapacitation, hypotension, and other signs and symptoms suggestive of high-level exposure); and the incident history, including system geometry, source-patient distance, and the suspected radiation dose distribution.

摘要

为在辐射事件后为患者提供适当的医疗护理，必须及时做出正确诊断并确定事件的相对严重程度。本文讨论了放射或核事件发生后的头24至72小时内高剂量辐射损伤和疾病的临床诊断与管理。为评估高剂量事件的严重程度，健康物理学家、医生和放射生物学家共同协作并评估许多变量非常重要，这些变量包括病史和体格检查结果；前驱症状和体征出现的时间（如恶心、呕吐、腹泻、短暂失能、低血压以及其他提示高水平暴露的症状和体征）；以及事件相关情况，包括系统几何形状、源与患者的距离以及疑似辐射剂量分布。