Clinical Treatment And Medical Follow-up Of A Systemic Excessive Exposure And Right Hand Radiation Injury Caused By¹⁹²Ir External Irradiation In A Flaw Detection Accident

ObjectiveTo discusse the treatment techniques of radiation injury and the application of the stromal vascular fraction(SVF)and adipose-derived stem cells(ADSCs)injection in the local trauma through the clinical treatment and 2 medical follow-up of a case of systemic over-exposure and right-hand local radiation injury caused by 192Ir external irradiation in a flaw detection accident,and accumulating experience in medical emergency for nuclear radiation accidents.Methods1.Review of medical treatment after the irradiation of the patient Ren(1)A review of the accident.(2)Dose estimation,clinical diagnosis and comprehensive treatment during hospitalization.2.Medical follow-up after irradiation.(1)Detailed medical history and physical examination.(2)Laboratory tests and equipment inspections.(3)Analysis chromosome aberrations in peripheral blood lymphocytesResult1.Review of medical treatment after exposure(1)Process of the accident,dose estimation and diagnosisCombined with the patient’s exposure dose,clinical manifestations and auxiliary examination results,the diagnosis was:192Ir excessive external irradiation;right hand(bump,food,middle,ring finger)acute radiation skin damage III degree.(2)Medical treatment during hospitalizationSystemic treatment and local treatment are equally important.In addition to systemic comprehensive treatment,local SVF and ADSCs injection were given during hospitalization.2.Medical follow-up results after exposure(1)The general condition of the whole body was acceptable at 2 times of follow-up.Before the second follow-up,the affected part of the right index finger showed repeated ulceration and pain.(2)Laboratory and device examinations:Laboratory follow-up results show that endocrine,hematopoietic and immune systems still have varying degrees of functional impairment after exposure.No obvious bone abnormalities were observed in the imaging examination.(3)Chromosome aberration analysis:Peripheral blood lymphocyte chromosomal aberration analysis still exists dicentric(dic).ConclusionA comprehensive review and follow-up records of the accidents of systemic over-irradiation and right-hand local radiation injury caused by 192Ir external irradiation,to provide a clinical reference for the comprehensive treatment and the application of SVF injection technology of external exposure accidents and important experience for long-term follow-up and long-term effects of radiation injury cases.