摘要
我国是核能发展和核辐射技术应用的大国,外照射急性综合征(ARS)的诊断与救治水平是我国核辐射事故卫生救援和医疗应急的核心能力之一。ARS临床上可表现为造血系统、胃肠道系统、皮肤和中枢神经系统综合征,其临床表现、严重程度和预后转归与受照剂量高度相关。我国已经建设了一批国家级和省级核辐射损伤救治基地,但一般医护人员少有治疗外照射急性放射病的经验。本共识总结了我国近年来的急性放射病救治经验,结合世界卫生组织(WHO)和国际原子能机构(IAEA)等国际组织的推荐建议,提出对ARS关键临床问题的证据,涵盖外照射急性放射病救治中的全部环节。首要的是基于临床症状和剂量估算做出临床诊断与分型分度,推荐了实施促进造血恢复、胃肠道损伤处理、感染处理、对症支持治疗、多器官功能保护等临床治疗措施,并列出了相关注意事项,做好中医药治疗、心理干预以及医疗随访,突出强调各临床学科团队协作的重要性。推荐给各有关救治基地临床应用。
China emerges as a major country in nuclear energy development and the application of nuclear and radiologic technology.The diagnosis and treatment of acute radiation syndrom(ARS)caused by external irradiation represent a core function in the country′s medical rescue of nuclear and radiological emergencies.Clinically,ARS manifests hematopoietic,gastrointestinal,cutaneous,and central nervous system syndromes,with specific clinical manifestations,signs,severity,and prognosis strongly correlated with radiation dose.China has established a number of national and provincial centers for treating radiation⁃induced damage.Nevertheless,most medical staff have limited experience in ARS treatment.This consensus presents a summary of recent experience in treating ARS of China.In combination with recommendations from international organizations such as the World Health Organization(WHO),this consensus proposes key evidence of critical clinical issues of ARS,covering all links in the rescue of external irradiation⁃induced ARS.Initially,clinical diagnosis,syndromes,and severe degrees should be determined based on clinical symptoms and dose estimates.It is necessary to normalize clinical treatment measures for hematopoietic recovery,gastrointestinal injury treatment,infection control,symptomatic treatment,and multi⁃organ function preservation.To this end,this consensus offers cautions.This consensus provides principles of treatment with traditional Chinese medicine,psychological intervention,and follow⁃up.Additionally,it highlights multidisciplinary collaboration.It is recommended that this consensus be applied in relevant treatment centers.
作者
梁莉
袁龙
余长林
刘青杰
刘玉龙
杨文峰
王进
黄伟旭
刘英
雷翠萍
陈惠芳
付熙明
曹宝山
王墨培
张照辉
肖宇
陈雅玫
孙全富
Liang Li;Yuan Long;Yu Changlin;Liu Qingjie;Liu Yulong;Yang Wenfeng;Wang Jin;Huang Weixu;Liu Ying;Lei Cuiping;Chen Huifang;Fu Ximing;Cao Baoshan;Wang Mopei;Zhang Zhaohui;Xiao Yu;Chen Yamei;Sun Quanfu(Department of Medical Oncology and Radiation Sickness,Peking University Third Hospital,Beijing 100191,China;National Institute for Radiological Protection,Chinese Center for Disease Control and Prevention,Beijing 100088,China;Fifth Medical Center,Chinese PLA General Hospital,Beijing 100039,China;Second Affiliated Hospital of Soochow University,Suzhou 215004,China;Jiangsu Provincial Center for Disease Control and Prevention,Nanjing 210008,China;Guangdong Province Hospital for Occupational Disease Prevention and Treatment,Guangzhou 510620,China)
出处
《中华放射医学与防护杂志》
北大核心
2025年第9期827-839,共13页
Chinese Journal of Radiological Medicine and Protection
关键词
外照射
急性放射病
剂量估算
诊断
治疗
External irradiation
Acute radiation sickness
Dose estimation
Diagnosis
Treatment
