1例放射性皮肤损伤患者15年医学随访观察

发布时间：2018-12-13 12:05

【摘要】：目的了解钴-60(60Co)源辐射所致放射皮肤损伤的变化规律。方法收集1起60Co源辐射事故中发生放射性皮肤损伤的患者"天"住院期间和受照后15年医学随访期间的皮肤专科临床资料进行分析。结果住院期间,"天"右手食指于受照后15 d出现红斑,受照后20 d出现边界清楚的水泡,受照后28 d水泡吸收,局部干燥、结痂;受照后33 d硬痂脱落;受照后91 d右手食指皮肤干燥、萎缩变薄、粗糙、弹性差;临床诊断为右手食指Ⅱ度急性放射性皮肤损伤。医学随访期间,"天"右手食指于受照后1年出现干燥、皲裂和角化过度等慢性病变,诊断为右手食指Ⅱ度慢性放射性皮肤损伤;受照后2、5、7、9和13年右手食指受照部位反复出现溃疡,伴有干燥、脱屑、色素减退、萎缩性疤痕、指甲纵裂和右手指伸展受限等体征;受照后15年,皮肤干燥、脱屑、皲裂,色素减退,出现萎缩性瘢痕。受照后2~15年随访期间均被诊断为右手食指Ⅲ度慢性放射性皮肤损伤。结论急性放射性皮肤损伤可迁延发展成为慢性放射性皮肤损伤,其恢复过程漫长。
[Abstract]:Objective to investigate the changes of radiation skin injury induced by cobalt 60 (60Co) source radiation. Methods the clinical data of patients with radiation-induced skin injury in a 60Co source radiation accident were collected during hospitalization and 15 years of medical follow-up after irradiation. Results during hospitalization, erythema appeared in the right index finger 15 days after irradiation, blisters with clear boundary appeared at 20 days after irradiation, blisters were absorbed at 28 days after irradiation, local drying and scabbing, and hard callus fell off 33 days after irradiation. 91 days after exposure, the skin of the right index finger was dry, shrunken, coarse and poor elasticity, and the clinical diagnosis was acute radiation injury of the right index finger. During the medical follow-up period, chronic diseases such as dryness, chapped and hyperkeratosis appeared in the right index finger of "Tian" one year after exposure, and were diagnosed as chronic radiation-induced skin injury of the right index finger. There were repeated ulcers in the irradiated part of the right index finger in the 2nd and 13th years after exposure, with signs such as dryness, desquamation, hypopigmentation, atrophic scar, longitudinal fissure of the nail and limited extension of the right finger, etc. 15 years after exposure, dry skin, detritus, chapped, pigmentation, atrophic scar. During the follow-up period of 2 to 15 years after irradiation, chronic radiation injury of the right index finger was diagnosed. Conclusion Acute radiation skin injury can be prolonged into chronic radiation skin injury, and the recovery process is long.
【作者单位】：中国医学科学院放射医学研究所;河南省职业病防治研究院;
【基金】：卫生部行业基金(201002009) 中国医学科学院放射医学研究所所立科研基金(1423) 天津市放射医学与分子核医学重点实验室
【分类号】：R818

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