中国职业医学
中國職業醫學
중국직업의학
CHINA OCCUPATIONAL MEDICINE
2015年
1期
39-42
,共4页
姜梅玲%邢志伟%姜恩海%于程程%江波%赵欣然%王晓光%赵凤玲%吕玉民%刘金星
薑梅玲%邢誌偉%薑恩海%于程程%江波%趙訢然%王曉光%趙鳳玲%呂玉民%劉金星
강매령%형지위%강은해%우정정%강파%조흔연%왕효광%조봉령%려옥민%류금성
辐射事故%钴-60%放射性疾病%皮肤损伤%医学随访
輻射事故%鈷-60%放射性疾病%皮膚損傷%醫學隨訪
복사사고%고-60%방사성질병%피부손상%의학수방
Radiation accident%60 Co%Radiation disease%Skin injury%Clinical follow-up
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。
目的：瞭解鈷-60（60Co）源輻射所緻放射皮膚損傷的變化規律。方法收集1起60Co源輻射事故中髮生放射性皮膚損傷的患者“天”住院期間和受照後15年醫學隨訪期間的皮膚專科臨床資料進行分析。結果住院期間，“天”右手食指于受照後15 d齣現紅斑，受照後20 d齣現邊界清楚的水泡，受照後28 d水泡吸收，跼部榦燥、結痂；受照後33 d硬痂脫落；受照後91 d右手食指皮膚榦燥、萎縮變薄、粗糙、彈性差；臨床診斷為右手食指Ⅱ度急性放射性皮膚損傷。醫學隨訪期間，“天”右手食指于受照後1年齣現榦燥、皸裂和角化過度等慢性病變，診斷為右手食指Ⅱ度慢性放射性皮膚損傷；受照後2、5、7、9和13年右手食指受照部位反複齣現潰瘍，伴有榦燥、脫屑、色素減退、萎縮性疤痕、指甲縱裂和右手指伸展受限等體徵；受照後15年，皮膚榦燥、脫屑、皸裂，色素減退，齣現萎縮性瘢痕。受照後2～15年隨訪期間均被診斷為右手食指Ⅲ度慢性放射性皮膚損傷。結論急性放射性皮膚損傷可遷延髮展成為慢性放射性皮膚損傷，其恢複過程漫長。
목적：료해고-60（60Co）원복사소치방사피부손상적변화규률。방법수집1기60Co원복사사고중발생방사성피부손상적환자“천”주원기간화수조후15년의학수방기간적피부전과림상자료진행분석。결과주원기간，“천”우수식지우수조후15 d출현홍반，수조후20 d출현변계청초적수포，수조후28 d수포흡수，국부간조、결가；수조후33 d경가탈락；수조후91 d우수식지피부간조、위축변박、조조、탄성차；림상진단위우수식지Ⅱ도급성방사성피부손상。의학수방기간，“천”우수식지우수조후1년출현간조、군렬화각화과도등만성병변，진단위우수식지Ⅱ도만성방사성피부손상；수조후2、5、7、9화13년우수식지수조부위반복출현궤양，반유간조、탈설、색소감퇴、위축성파흔、지갑종렬화우수지신전수한등체정；수조후15년，피부간조、탈설、군렬，색소감퇴，출현위축성반흔。수조후2～15년수방기간균피진단위우수식지Ⅲ도만성방사성피부손상。결론급성방사성피부손상가천연발전성위만성방사성피부손상，기회복과정만장。
Objective To explore the changing characteristics of skin injury caused by Co-60(60 Co) ionizing radiation. Methods The dermatology clinical data of the patient “Tian” who suffered skin injury from a 60 Co radiation source accident was collected and analyzed during his hospital stay and the 15-year-long clinical follow up .Results During the hospital stay , red spot was observed in the right forefinger of “Tian” on day 15 after ionizing radiation , followed by formation of vesicles with clear boundary on day 20.The vesicles absorption happened on day 28 and the local skin became dry and developed to scab , which fell off on day 33.Ninety-one days after ionizing radiation , dry skin, atrophy and getting thin, rough and poor elasticity were found in the right forefinger , which was clinically diagnosed as Ⅱ degree of acute radiation skin injury .One year after the ionizing radiation , some chronic clinical signs , such as dry , chapped skin and hyperkeratosis , were found in this forefinger with diagnosis as Ⅱ degree of chronic radiation skin damage .Frequentative ulcer, together with dry, furfuration, pigment decline, atrophic scar, longitudinal crack on the nail and limited stretch of right forefinger were observed in year 2, 5, 7, 9, 13 after ionizing radiation.In the 15th year, the right forefinger showed dry, furfuration, chapped skin, pigment decline and atrophic scar were observed .During the following up from the 2nd to the 15th year,“Tian” was diagnosed as Ⅲ degree of chronic radiation skin injury .Conclusion Acute skin radiation injury can slowly develop to chronic radiation skin injury , which needs a very long time to recover .
