What does radiation sickness mean? Symptoms of various forms of radiation sickness

What's happened Radiation sickness
Symptoms of Radiation Sickness
Diagnosis of Radiation Sickness
Treatment of Radiation Sickness
Which doctors should you contact if you have radiation sickness?

What is Radiation Sickness

Radiation sickness is formed under the influence of radioactive radiation in the dose range of 1-10 Gy or more. Some changes observed during irradiation at doses of 0.1-1 Gy are regarded as preclinical stages of the disease. There are two main forms of radiation sickness, which form after general, relatively uniform irradiation, as well as with very narrowly localized irradiation of a certain segment of the body or organ. Combined and transitional forms are also noted.

Pathogenesis (what happens?) during Radiation sickness

Radiation sickness is divided into acute (subacute) and chronic form depending on the time distribution and absolute value of radiation exposure, which determine the dynamics of developing changes. The uniqueness of the mechanism of development of acute and chronic radiation sickness excludes the transition of one form to another. The conventional boundary delimiting acute or chronic forms is the accumulation over the course of short term(from 1 hour to 1-3 days) total tissue dose equivalent to that from exposure to 1 Gy of external penetrating radiation.

Lead development clinical syndromes acute radiation sickness depends on external radiation doses, which cause the variety of lesions observed. In addition, the type of radiation also plays an important role, each of which has certain characteristics, which are associated with differences in their damaging effect on organs and systems. Thus, a-radiation is characterized by high density ionization and low penetrating ability, and therefore these sources cause a spatially limited damaging effect.

Beta radiation, which has weak penetrating and ionizing ability, causes tissue damage directly in areas of the body adjacent to the radioactive source. On the contrary, y-radiation and x-rays cause deep damage to all tissues in the area of their action. Neutron radiation causes significant heterogeneity in the damage to organs and tissues, since their penetrating ability, as well as linear energy losses along the path of the neutron beam in tissues, are different.

In the case of irradiation with a dosage of 50-100 Gy, damage to the central nervous system determines the leading role in the mechanism of development of the disease. With this form of the disease, death occurs, as a rule, on the 4-8th day after exposure to radiation.

When irradiated in doses from 10 to 50 Gy, symptoms of damage to the gastrointestinal tract with mucosal rejection come to the fore in the mechanism of development of the main manifestations of the radiation clinical picture of the disease small intestine leading to death within 2 weeks.

Under the influence of a lower dose of radiation (from 1 to 10 Gy), symptoms typical of acute radiation sickness are clearly visible, the main manifestation of which is hematological syndrome, accompanied by bleeding and all kinds of complications of an infectious nature.

Damage to the gastrointestinal tract, various structures of both the brain and spinal cord, as well as the hematopoietic organs, is characteristic of exposure to the above radiation doses. The severity of such changes and the speed of development of disorders depend on the quantitative parameters of exposure.

Symptoms of Radiation Sickness

In the formation and development of the disease, the following phases are clearly distinguished: Phase I - primary general reaction; Phase II - apparent clinical well-being (skeletal, or latent, phase); Phase III - pronounced symptoms of the disease; Phase IV is the period of restoration of structure and function.

In the event that acute radiation sickness occurs in a typical form, in its clinical picture Four degrees of severity can be distinguished. Symptoms characteristic of each degree of acute radiation sickness are determined by the dose of radioactive radiation that the patient received:

1) mild degree occurs when irradiated at a dose of 1 to 2 Gy;

2) moderate severity - the radiation dose ranges from 2 to 4 Gy;

3) severe - the radiation dose ranges from 4 to 6 Gy;

4) extremely severe degree occurs when irradiated at a dose exceeding 6 Gy.

If the patient received a dose of radioactive radiation in a dose of less than 1 Gy, then we have to talk about the so-called radiation injury, which occurs without any obvious symptoms diseases.

Severe disease is accompanied by recovery processes that last a long time over 1-2 years. In cases where any changes remain that become permanent, in the future we should talk about the consequences of acute radiation sickness, and not about the transition acute form diseases into chronic ones.

Phase I of the primary general reaction is observed in all individuals when exposed to doses exceeding 2 Gy. The time it appears depends on the dose of penetrating radiation and is calculated in minutes and hours. Characteristic signs of a reaction include nausea, vomiting, a feeling of bitterness or dry mouth, weakness, fatigue, drowsiness, and headache.

Shock-like conditions may develop, accompanied by a decrease in blood pressure, loss of consciousness, possibly an increase in temperature, as well as diarrhea. These symptoms usually occur with radiation doses exceeding 10 Gy. Transient redness of the skin with a slightly bluish tint is detected only in areas of the body that have been irradiated at a dose exceeding 6-10 Gy.

Patients have some variability in pulse and blood pressure with a tendency to decrease; a uniform overall decrease is characteristic muscle tone, trembling of fingers, decreased tendon reflexes. Changes

electroencephalograms indicate moderate diffuse inhibition of the cerebral cortex.

During the first days after irradiation, neutrophilic leukocytosis is observed in the peripheral blood with the absence of noticeable rejuvenation in the formula. Subsequently, over the next 3 days, the level of lymphocytes in the blood decreases in patients, this is associated with the death of these cells. The number of lymphocytes 48-72 hours after irradiation corresponds to the received radiation dose. The number of platelets, erythrocytes and hemoglobin in these periods after irradiation does not change against the background of myelokaryocytopenia.

A day later, the myelogram reveals an almost complete absence of such young forms as myeloblasts, erythroblasts, a decrease in the content of pronormoblasts, basophilic normoblasts, promyelocytes, and myelocytes.

In phase I of the disease, at radiation doses exceeding 3 Gy, some biochemical changes are detected: a decrease in serum albumin, an increase in blood glucose levels with a change in the sugar curve. In more severe cases, moderate transient bilirubinemia is detected, thereby indicating disorders metabolic processes in the liver, in particular decreased absorption of amino acids and increased protein breakdown.

Phase II - the phase of imaginary clinical well-being, the so-called hidden, or latent phase, is noted after the disappearance of signs of the primary reaction 3-4 days after irradiation and lasts for 14-32 days. The well-being of patients during this period improves; only some lability in the pulse rate and blood pressure level remains. If the radiation dose exceeds 10 Gy, the first phase of acute radiation sickness directly passes into the third.

From the 12th to 17th day, in patients exposed to radiation at a dose exceeding 3 Gy, baldness is detected and progresses. During these periods, other skin lesions also appear, which are sometimes prognostically unfavorable and indicate a high dose of radiation.

In phase II, neurological symptoms become more pronounced (impaired movements, coordination, involuntary trembling of the eyeballs, organic movements, mild symptoms pyramidal insufficiency, decreased reflexes). The EEG shows the appearance of slow waves and their synchronization with the pulse rhythm.

In the peripheral blood, by the 2-4th day of the disease, the number of leukocytes decreases to 4 H 109/l due to a decrease in the number of neutrophils (first decrease). Lymphocytopenia persists and progresses somewhat. Thrombocytopenia and reticulocytopenia appear on days 8-15. The number of red blood cells does not decrease significantly. By the end of phase II, a slowdown in blood clotting is detected, as well as a decrease in the stability of the vascular wall.

The myelogram reveals a decrease in the number of more immature and mature cells. Moreover, the content of the latter decreases in proportion to the time elapsed after irradiation. By the end of phase II, only mature neutrophils and single polychromatophilic normoblasts are found in the bone marrow.

results biochemical research blood indicate a slight decrease in the albumin fraction of serum proteins, normalization of blood sugar and serum bilirubin levels.

IN III phase, occurring with pronounced clinical symptoms, the timing of onset and the degree of intensity of individual clinical syndromes depend on the dose of ionizing radiation; The duration of the phase ranges from 7 to 20 days.

Damage to the blood system is dominant in this phase of the disease. Along with this, immunosuppression, hemorrhagic syndrome, the development of infections and autointoxication occur.

By the end of the latent phase of the disease, the condition of the patients deteriorates significantly, resembling a septic condition with characteristic symptoms: increasing general weakness, rapid pulse, fever, low blood pressure. Pronounced swelling and bleeding of the gums. In addition, the mucous membranes of the oral cavity and gastrointestinal tract are affected, which manifests itself in the appearance large quantity necrotic ulcers. Ulcerative stomatitis occurs when irradiated in doses of more than 1 Gy on the oral mucosa and lasts about 1-1.5 months. The mucous membrane almost always recovers completely. With high doses of radiation, severe inflammation of the small intestine develops, characterized by diarrhea, fever, bloating and pain in the ileal region. At the beginning of the 2nd month of the disease, radiation inflammation of the stomach and esophagus may occur. Infections most often manifest themselves in the form of ulcerative-erosive sore throats and pneumonia. The leading role in their development is played by autoinfection, which acquires pathogenic significance against the background of a pronounced inhibition of hematopoiesis and suppression of the immunobiological reactivity of the body.

Hemorrhagic syndrome manifests itself in the form of hemorrhages, which can be localized in completely different places: the heart muscle, skin, mucous membrane of the respiratory and urinary tract, gastrointestinal tract, central nervous system, etc. The patient experiences heavy bleeding.

Neurological symptoms are a consequence of general intoxication, infection, and anemia. There are increasing general lethargy, adynamia, blackout, meningeal symptoms, increased tendon reflexes, decreased muscle tone. Usually, signs of increasing edema of the brain and its membranes are detected. Slow pathological waves appear on the EEG.

Diagnosis of Radiation Sickness

The hemogram shows a second sharp decrease in the number of leukocytes due to neutrophils (preserved neutrophils with pathological granularity), lymphocytosis, plasmatization, thrombocytopenia, anemia, reticulocytopenia, and a significant increase in ESR.

The beginning of regeneration is confirmed by an increase in the number of leukocytes, the appearance of reticulocytes in the hemogram, as well as a sharp shift in the leukocyte formula to the left.

Painting bone marrow with lethal doses of radiation, it remains devastated throughout the entire III phase of the disease. At lower doses, after a 7-12-day period of aplasia, blast elements appear in the myelogram, and then the number of cells of all generations increases. With moderate severity of the process in the bone marrow from the first days of phase III against the background of a sharp decrease total number myelokaryocytes show signs of hematopoietic repair.

Biochemical studies reveal hypoproteinemia, hypoalbuminemia, a slight increase in the level residual nitrogen, decrease in the amount of blood chlorides.

Phase IV - the immediate recovery phase - begins with normalization

temperatures, improvements general condition sick.

In case there was severe course acute radiation sickness, in patients the pastiness of the face and limbs persists for a long time. The remaining hair becomes dull, dry and brittle; new hair growth at the site of baldness resumes 3-4 months after irradiation.

Pulse and arterial pressure normalizes, sometimes moderate hypotension remains for a long time.

For some time, hand tremors, static incoordination, a tendency to increase tendon and periostenal reflexes, and some unstable focal neurological symptoms have been noted. The latter are regarded as the result of functional disorders cerebral circulation, as well as depletion of neurons against the background of general asthenia.

There is a gradual recovery of peripheral blood parameters. The number of leukocytes and platelets increases and by the end of the 2nd month reaches lower limit norms. IN leukocyte formula there is a sharp shift to the left to promyelocytes and myeloblasts, the content of band forms reaches 15-25%. The number of monocytes is normalized. By the end of the 2-3rd month of the disease, reticulocytosis is detected.

Until the 5-6th week of the disease, anemia continues to increase with phenomena of anisocytosis of erythrocytes due to macroforms.

The myelogram reveals signs of pronounced restoration of hematopoietic cells: an increase in the total number of myelokaryocytes, the predominance of immature cells of erythro- and leukopoiesis over mature ones, the appearance of megakaryocytes, an increase in the number of cells in the mitotic phase. Biochemical parameters are normalized.

Characteristic long-term consequences of severe acute radiation sickness are the development of cataracts, moderate leuko-, neutro- and thrombocytopenia, persistent focal neurological symptoms, and sometimes endocrine changes.

V persons exposed to radiation, in the long term, leukemia develops 5-7 times
more often.

The mechanism of development of the observed changes in hematopoiesis at various stages of acute radiation sickness is associated with different radiosensitivity of individual cellular elements. Thus, blast forms and lymphocytes of all generations are highly radiosensitive. Promyelocytes, basophilic erythroblasts and immature monocytoid cells are relatively radiosensitive. Mature cells are highly radioresistant.

On the first day after total irradiation at a dose exceeding 1 Gy, massive death of lymphoid and blast cells occurs, and with an increase in the irradiation dose, more mature cellular elements of hematopoiesis occur.

At the same time, the massive death of immature cells does not affect the number of granulocytes and erythrocytes in peripheral blood. The only exceptions are lymphocytes, which themselves are highly radiosensitive. The neutrophilic leukocytosis that occurs is mainly redistributive in nature.

Simultaneously with interphase death, the mitotic activity of hematopoietic cells is suppressed while maintaining their ability to mature and enter the peripheral blood. As a result, myelokaryocytopenia develops.

Severe neutropenia in phase III of the disease is a reflection of depletion of the bone marrow and almost complete absence it contains all granulocytic elements.

At approximately the same time, a maximum decrease in the number of platelets in the peripheral blood is observed.

The number of red blood cells decreases even more slowly, since their lifespan is about 120 days. Even if the flow of red blood cells into the blood completely stops, their number will decrease daily by approximately 0.85%. Therefore, a decrease in the number of erythrocytes and Hb content is usually detected only in phase IV - the recovery phase, when the natural loss of erythrocytes is already significant and has not yet been compensated by newly formed ones.

Treatment of Radiation Sickness

In case of irradiation at a dose of 2.5 Gy or higher, deaths. A dose of 4 ± 1 Gy is approximately considered average lethal for humans, although in cases of irradiation at a dose of 5-10 Gy, clinical recovery with proper and timely treatment still possible. When irradiated at a dose of more than 6 Gy, the number of survivors is practically reduced to zero.

To establish the correct tactics for managing patients, as well as predicting acute radiation sickness in exposed patients, dosimetric measurements are carried out, which indirectly indicate the quantitative parameters of radioactive exposure on tissue.

The dose of ionizing radiation absorbed by the patient can be determined on the basis of chromosomal analysis of hematopoietic cells, determined in the first 2 days after irradiation. During this period, per 100 peripheral blood lymphocytes, chromosomal abnormalities amount to 22-45 fragments in the first degree of severity, 45-90 fragments in the second degree, 90-135 fragments in the third degree, and more than 135 fragments in the fourth, extremely severe degree of the disease.

In phase I of the disease, aeron is used to relieve nausea and prevent vomiting; in cases of repeated and indomitable vomiting, aminazine and atropine are prescribed. In case of dehydration, saline infusions are necessary.

In case of severe acute radiation sickness, during the first 2-3 days after irradiation, the doctor carries out detoxification therapy (for example, polyglucin). They are used well to combat collapse known remedies- cardamine, mesaton, norepinephrine, as well as kinin inhibitors: trasylol or contrical.

Prevention and treatment infectious complications

The system of measures aimed at preventing external and internal infections uses isolators of various types with a supply of sterile air, sterile medical materials, care items and food. The skin and visible mucous membranes are treated with antiseptics; non-absorbable antibiotics (gentamicin, kanamycin, neomycin, polymyxin-M, ristomycin) are used to suppress the activity of intestinal flora. At the same time, they are prescribed orally large doses nystatin (5 million units or more). In cases where the level of leukocytes decreases below 1000 per 1 mm3, prophylactic use of antibiotics is advisable.

When treating infectious complications, large doses of intravenously administered antibacterial drugs wide range actions (gentamicin, ceporin, kanamycin, carbenicillin, oxacillin, methicillin, lincomycin). When a generalized fungal infection occurs, amphotericin B is used.

It is advisable to intensify antibacterial therapy biological drugs targeted action (antistaphylococcal plasma and γ-globulin, antipseudomonal plasma, hyperimmune plasma against Escherichia coli).

If no positive effect is observed within 2 days, the doctor changes antibiotics and then prescribes them taking into account the results of bacteriological cultures of blood, urine, feces, sputum, smears from the oral mucosa, as well as external local infectious foci, which are performed on the day of admission and beyond. -in one day. In cases of accession viral infection Acyclovir can be used with effect.

The fight against bleeding includes the use of general and local hemostatic agents. In many cases, strengthening agents are recommended vascular wall(dicinone, steroid hormones, ascorbic acid, rutin) and those that increase blood clotting (E-AKK, fibrinogen).

In the vast majority of cases, thrombocytopenic bleeding can be stopped by transfusion of an adequate amount of freshly prepared donor platelets obtained by thrombocytopenia. Platelet transfusions are indicated in cases of deep thrombocytopenia (less than 20 109/l), occurring with hemorrhages on the facial skin, upper half torso, on the fundus, with local visceral bleeding.

Anemic syndrome rarely develops in acute radiation sickness. Transfusions of red blood cells are prescribed only when the hemoglobin level decreases below 80 g/l.

Transfusions of freshly prepared red blood cells, washed or thawed red blood cells are used. IN in rare cases There may be a need for individual selection not only for the AB0 system and Rh factor, but also for other erythrocyte antigens (Kell, Duffy, Kidd).

Treatment of ulcerative-necrotic lesions of the mucous membranes of the gastrointestinal tract.

In the prevention of ulcerative necrotic stomatitis, rinsing the mouth after meals (with a 2% soda solution or a 0.5% novocaine solution) is important, as well as antiseptics(1% hydrogen peroxide, 1% solution 1: 5000 furatsilin; 0.1% gramicidin, 10% aqueous-alcohol emulsion of propolis, lysozyme). In cases of candidiasis, nystatin and levorin are used.

One of severe complications agranulocytosis and direct exposure to radiation is necrotizing enteropathy. The use of biseptol or antibiotics that sterilize the gastrointestinal tract helps reduce clinical manifestations or even preventing its development. If necrotic enteropathy occurs, the patient is prescribed complete fasting. In this case, only reception is allowed boiled water and drugs that relieve diarrhea (dermatol, bismuth, chalk). In severe cases of diarrhea use parenteral nutrition.

Bone marrow transplantation

Allogeneic histocompatible bone marrow transplantation is indicated only in cases characterized by irreversible depression of hematopoiesis and profound suppression of immunological reactivity.

Therefore this method has limited opportunities, since there are still enough effective measures overcoming tissue incompatibility reactions.

The selection of a bone marrow donor is made necessarily taking into account the transplant antigens of the HLA system. In this case, the principles established for allomyelotransplantation with preliminary immunosuppression of the recipient (use of methotrexate, irradiation of blood transfusion media) must be observed.

Special attention should be paid to general uniform radiation used as a pre-transplant immunosuppressive and antitumor agent in a total dose of 8-10 Gy. The observed changes differ in a certain pattern; the severity of individual symptoms varies from patient to patient.

The primary reaction that occurs after radiation exposure at a dose of more than 6 Gy is the appearance of nausea (vomiting), chills against the background elevated temperature, a tendency to hypotension, a feeling of dry mucous membranes of the nose and lips, a bluish complexion, especially the lips and neck. The general irradiation procedure is carried out in a specially equipped irradiator under constant visual observation of the patient using television cameras in the conditions of two-way communication. If necessary, the number of breaks can be increased.

Description:

Radiation sickness is a disease resulting from exposure to various types ionizing radiation and characterized by a symptom complex depending on the type of damaging radiation, its dose, localization of the source of radioactive substances, dose distribution in time and the human body.

Symptoms:

The clinical manifestations of the disease depend on the total dose of radiation, as well as its distribution over time and in the human body. Depending on the nature of the spatial distribution of the dose, radiation sickness caused by uniform (general), local and uneven irradiation is distinguished, and according to the distribution of the dose over time, acute and chronic radiation sickness are distinguished. The development of the disease can be caused by both external radiation and exposure to radionuclides entering the body.

Acute radiation sickness in humans develops with short-term (from several minutes to 1-3 days) irradiation of the whole body at a dose exceeding 1 Gy. It can occur when a person is in the area of radiation or radioactive fallout, violation of the operating conditions of powerful radiation sources leading to an accident, or the use of general irradiation for therapeutic purposes.

The main manifestations of acute radiation sickness are determined by damage to hematopoiesis with the development of bone marrow aplasia and complications caused by cytopenia - hemorrhagic syndrome, infectious lesions organs, sepsis; disruption of physiological reproduction of the epithelium small intestine with exposure of the mucous membrane, loss of protein, fluid and electrolytes; severe intoxication due to massive destruction of radiosensitive tissues (bone marrow, small intestine, and also skin - with extensive damage by weakly penetrating external beta radiation); direct damage to the central nervous system with disruption of its functions, especially the central regulation of blood circulation and respiration. In accordance with this, bone marrow, intestinal, toxemic, neurocerebral and transitional forms of acute radiation sickness are distinguished, which arise respectively after general irradiation in the following dose ranges: 1 - 10, 10 - 50, 50-100 and more than 100 Gy.

The bone marrow form of acute radiation sickness can be effectively treated. During the period of its formation, 4 phases are clearly distinguished: the phase of the primary reaction, the latent phase, the phase of height, or pronounced clinical manifestations, and the phase early recovery. The duration of the disease is about 2 - 3 months from the moment of irradiation (for more severe lesions up to 3 - 6 months)

Acute radial lung disease(I) degree occurs when exposed to ionizing radiation at a dose of 1-2.5 Gy. A moderately severe primary reaction (dizziness, rarely nausea) is observed 2-3 hours after irradiation. Changes in the skin and mucous membranes, as a rule, are not detected. The latent phase lasts 25-30 days. The number of lymphocytes (in 1 μl of blood) in the first 1-3 days decreases to 1000 - 500 cells (1-0.5 109 / l), leukocytes at the height of the disease - to 3500-1500 (3.5 - 1.5 109 / l), platelets on days 26-28 - up to 60,000-10,000 (60-40,109/l); ESR increases moderately. Infectious complications occur rarely. No bleeding is observed. The recovery is slow but complete.

Acute radiation sickness of moderate (II) degree develops when exposed to ionizing radiation at a dose of 2.5 - 4 Gy. The primary reaction (headache, sometimes) occurs after 1-2 hours. Skin erythema may appear. The latent phase lasts 20 - 25 days. The number of lymphocytes in the first 7 days decreases to 500, the number of granulocytes in the peak phase (20-30 days) - to 500 cells in 1 μl of blood (0.5 109/l); ESR - 25 -40 mm/h. Infectious complications, changes in the mucous membrane of the mouth and pharynx are characteristic; when the number of platelets is less than 40,000 in 1 μl of blood (40,109/l), minor signs of bleeding are detected - petechiae in the skin. Fatal outcomes are possible, especially with delayed and inadequate treatment.

Acute radiation sickness of severe (III) degree is observed when. exposure to ionizing radiation at a dose of 4 - 10 Gy. The primary reaction occurs after 30 - 60 minutes and is pronounced (repeated vomiting, increased body temperature, skin erythema). The number of lymphocytes on the first day is 300 - 100, leukocytes from days 9-17 - less than 500, platelets - less than 20,000 in 1 μl of blood. The duration of the latent phase does not exceed 10 -15 days. At the height of the disease, severe fever, lesions of the mucous membrane of the mouth and nasopharynx, and infectious complications are noted. of various etiologies(bacterial, viral, fungal) and localization (lungs, intestines, etc.), moderate bleeding. The frequency of deaths increases (in the first 4 - 6 weeks).

Acute radiation sickness of extremely severe (IV) degree occurs when exposed to ionizing radiation at a dose of more than 10 Gy. Symptoms are caused by deep damage to hematopoiesis, characterized by early persistent lymphopenia - less than 100 cells in 1 μl of blood (0.1 109/l), agranulocytosis, starting from the 8th day, thrombocytopenia - less than 20,000 in 1 μl of blood (20 109/l) and then anemia. As the dose increases, all manifestations become more severe, the duration of the latent phase is reduced, and damage to other organs (intestines, skin, brain) and general symptoms become paramount. Deaths are almost inevitable.

With an increase in the severity of acute radiation sickness in persons who survived the period of its formation, the completeness of subsequent recovery decreases, the residual effects of hematopoietic damage (thrombocytopenia and), dystrophic changes in the skin develop, progress, and signs of asthenia appear.

Causes:

In humans, radiation sickness can be caused by external irradiation and internal irradiation - when radioactive substances enter the body with inhaled air, through the gastrointestinal tract or through the skin and mucous membranes, as well as as a result of injection.

The general clinical manifestations of radiation sickness depend mainly on the total dose of radiation received. Doses up to 1 Gy (100 rad) cause relatively mild changes that can be considered a pre-disease state. Doses above 1 Gy cause bone marrow or intestinal forms of radiation sickness varying degrees severity, which depend mainly on damage to the hematopoietic organs. Single radiation doses of more than 10 Gy are considered absolutely lethal.

Treatment:

For treatment the following is prescribed:

Treatment consists of ensuring an aseptic regime (in special or adapted wards), preventing infectious complications and prescribing symptomatic remedies. When fever develops, even without identifying foci of infection, broad-spectrum antibiotics are used according to indications ( herpetic infection) antiviral drugs. To increase the effectiveness of anti-infective therapy, hyperimmune plasma and gamma globulin preparations are prescribed.

Replacement of platelet deficiency (less than 20,000 cells in 1 μl of blood) is carried out by introducing platelet mass obtained, if possible, from one donor (300 109/l cells per infusion), after preliminary irradiation at a dose of 15 Gy. According to indications (anemia - less than 2,500,000 red blood cells in 1 μl of blood), transfusions of washed fresh red blood cells are performed.

With total irradiation in the dose range of 8-12 Gy, the absence of contraindications and the presence of a donor, a bone marrow transplant is justified, taking into account tissue compatibility.

Local lesions of the mucous membranes require systematic special care and treatment of the mouth, nose, and pharynx with bactericidal and mucolytic drugs. For the treatment and anesthesia of skin lesions, aerosols and collagen films, moisturizing dressings with tanning and antiseptic agents, and later ointment dressings with hydrocortisone derivatives based on wax and propolis are used. Non-healing wound and ulcerative lesions are excised followed by plastic surgery. Correction of water-electrolyte and other metabolic disorders carried out according to general rules intensive care.

In cases mass casualties acute radiation sickness is often combined with exposure to thermal, chemical or mechanical factors. In these cases, it is necessary to somewhat simplify the treatment methods due to the difficulties of their full implementation (prescribing long-acting drugs orally, treating wounds under a bandage, observing the simplest asepsis regimen, etc.).

The main means of prevention are measures that limit the levels of exposure to the whole body and its individual parts: shielding, limiting the time spent in intense radiation fields, taking special preventive agents.

Modern people have a vague understanding of radiation and its consequences, because the last large-scale disaster occurred more than 30 years ago. Ionizing radiation is invisible, but can cause dangerous and irreversible changes in human body. In large, single doses, it is absolutely lethal.

What is radiation sickness?

This term means pathological condition caused by exposure to any type of radiation. It is accompanied by symptoms that depend on several factors:

type of ionizing radiation;
dose received;
the rate at which radiation exposure enters the body;
source localization;
dose distribution in the human body.

Acute radiation sickness

This pathology occurs as a result of uniform exposure to large amounts of radiation. Acute radiation sickness develops at radiation doses exceeding 100 rad (1 Gy). This volume of radioactive particles must be received once, over the course of short period time. Radiation sickness of this form immediately causes noticeable clinical manifestations. At doses of more than 10 Gy, a person dies after short suffering.

Chronic radiation sickness

The type of problem under consideration is a complex clinical syndrome. The chronic course of the disease is observed if the doses of radioactive radiation are low, amounting to 10-50 rads per day for a long time. Specific signs of pathology appear when the total amount of ionization reaches 70-100 rad (0.7-1 Gy). Difficulty timely diagnosis and subsequent treatment consists of intensive processes of cellular renewal. Damaged tissue are restored, and the symptoms remain unnoticeable for a long time.

The characteristic signs of the described pathology arise under the influence of:

x-ray radiation;
ions, including alpha and beta;
gamma rays;
neutrons;
protons;
muons and other elementary particles.

Causes of acute radiation sickness:

man-made disasters in the field of nuclear energy;
use of total irradiation in oncology, hematology, rheumatology;
use of nuclear weapons.

Radiation sickness with chronic course develops against the background:

frequent x-ray or radionuclide studies in medicine;
professional activities related to ionizing radiation;
consuming contaminated food and water;
living in a radioactive area.

Forms of radiation sickness

The types of pathology presented are classified separately for acute and chronic diseases. In the first case, the following forms are distinguished:

Bone marrow. Corresponds to a radiation dose of 1-6 Gy. This is the only type of pathology that has degrees of severity and periods of progression.
Transitional. Develops after exposure to ionizing radiation at a dose of 6-10 Gy. Dangerous condition, sometimes ending in death.
Intestinal. Occurs when exposed to radiation of 10-20 Gy. Specific signs are observed in the first minutes of the lesion, death occurs after 8-16 days due to the complete loss of the intestinal epithelium.
Vascular. Another name is the toxemic form of acute radiation sickness, corresponding to an ionization dose of 20-80 Gy. Death occurs within 4-7 days due to severe hemodynamic disturbances.
Cerebral (fulminant, acute). The clinical picture is accompanied by loss of consciousness and a sharp drop in blood pressure after exposure to radiation of 80-120 Gy. Lethal outcome is observed in the first 3 days, sometimes a person dies within a few hours.
Death under the beam. At doses of more than 120 Gy, a living organism dies instantly.

Radial chronic illness divided into 3 types:

Basic. External uniform exposure to radiation over a long period of time.
Heterogeneous. Includes both external and internal irradiation with a selective effect on certain organs and tissues.
Combined. Uneven exposure to radiation (local and systemic) with overall impact for the whole body.

Degrees of radiation sickness

The severity of the violation in question is assessed according to the amount of radiation received. Degrees of manifestation of radiation sickness:

light – 1-2 Gy;
moderate - 2-4 Gy;
heavy – 4-6 Gy;
extremely severe - more than 6 Gy.

Radiation sickness - symptoms

The clinical picture of the pathology depends on its form and the degree of damage to internal organs and tissues. General signs of radiation sickness at a mild stage:

weakness;
nausea;
headache;
pronounced blush;
drowsiness;
fatigue;
feeling of dryness.

Symptoms of more severe radiation exposure:

vomit;
fever;
diarrhea;
severe redness of the skin;
fainting;
Strong headache;
hypotension;
unclear pulse;
lack of coordination;
convulsive twitching of the limbs;
lack of appetite;
bleeding;
formation of ulcers on the mucous membranes;
hair loss;
thinning, brittle nails;
dysfunction of the genital organs;
infections respiratory tract;
trembling fingers;
disappearance of tendon reflexes;
decreased muscle tone;
internal hemorrhages;
deterioration of higher brain activity;
hepatitis and others.

Periods of radiation sickness

Acute radiation damage occurs in 4 stages. Each period depends on the stage of radiation sickness and its severity:

Primary reaction. The initial stage lasts 1-5 days, its duration is calculated depending on the radiation dose received - the amount in Gy + 1. The main symptom of the primary reaction is considered acute, which includes 5 basic signs - headache, weakness, vomiting, redness of the skin and body temperature.
Imaginary well-being. The “walking corpse” phase is characterized by the absence of a specific clinical picture. The patient thinks that radiation sickness has subsided, but pathological changes progress in the body. The disease can be diagnosed only by abnormalities in blood composition.
The height of At this stage, most of the symptoms listed above are observed. Their severity depends on the severity of the lesion and the dose of ionizing radiation received.
Recovery. With an acceptable amount of radiation compatible with life and adequate therapy, recovery begins. All organs and systems gradually return to normal functioning.

Radiation sickness - treatment

Therapy is developed after the results of the examination of the affected person. Effective treatment radiation sickness depends on the degree of damage and severity of the pathology. When receiving small doses of radiation, it comes down to relieving the symptoms of poisoning and cleansing the body of toxins. In severe cases, special therapy is required aimed at correcting all the resulting disorders.

Radiation sickness - first aid

If a person is exposed to radiation, a team of specialists should be called immediately. Before their arrival, you need to perform some manipulations.

Acute radiation sickness - first aid:

Completely undress the victim (the clothing is then disposed of).
Wash your body thoroughly in the shower.
Rinse your eyes, mouth and nasal cavity well with soda solution.
Rinse the stomach and intestines.
Give an antiemetic (Metoclopramide or any equivalent).

Acute radiation sickness - treatment

Upon admission to the hospital hospital, a person is placed in a sterile room (box) to prevent infection and other complications of the described pathology. Radiation sickness requires the following therapeutic regimen:

Stop vomiting. Ondansetron, Metoclopramide, and the antipsychotic Chlorpromazine are prescribed. If you have an ulcer, platyphylline hydrotartrate or atropine sulfate are better options.
Detoxification. Droppers with physiological and glucose solutions and Dextran preparations are used.
Replacement therapy. Severe radiation sickness requires parenteral nutrition. For this purpose, fat emulsions and solutions with high content microelements, amino acids and vitamins - Intralipid, Lipofundin, Infezol, Aminol and others.
Restoration of blood composition. To accelerate the formation of granulocytes and increase their concentration in the body, Filgrastim is administered intravenously. Most patients with radiation sickness are additionally required to receive daily blood transfusions.
Treatment and prevention of infections. Strong ones are needed - Methyllicin, Tseporin, Kanamycin and analogues. Drugs help increase their effectiveness biological type, for example, hyperimmune, antistaphylococcal plasma.
Activity Suppression intestinal microflora and fungi. In this case, antibiotics are also prescribed - Neomycin, Gentamicin, Ristomycin. To prevent candidiasis, Nystatin and Amphotericin B are used.
Virus therapy. Acyclovir is recommended as a preventive treatment.
Fighting bleeding. Improvement of blood clotting and strengthening of vascular walls is provided by steroid hormones, Dicynon, Rutin, fibrinogen protein, and the drug E-AKK.
Restoring microcirculation and preventing the formation of blood clots. Heparins are used - Nadroparin, Enoxaparin and synonyms.
Relief of inflammatory processes. Maximum quick effect produces Prednisolone in small doses.
Prevention of collapse. Indicated, Niketamide, Phenylephrine, Sulfocamphocaine.
Improvement of neuroendocrine regulation. Novocaine is administered intravenously, B vitamins and calcium gluconate are additionally used.
Antiseptic treatment of ulcers on mucous membranes. It is recommended to rinse with soda or novocaine solution, Furacilin, hydrogen peroxide, propolis emulsion and similar means.
Local therapy for affected skin. Wet dressings with Rivanol, Linol, Furacilin are applied to the burned areas.
Symptomatic treatment. Depending on the existing symptoms, patients are prescribed sedatives, antihistamines, painkillers, and tranquilizers.

Chronic radiation sickness - treatment

The main aspect of therapy in this situation is the cessation of contact with radiation. At mild degree lesions it is recommended:

fortified diet;
physiotherapy;
natural stimulants of the nervous system (schisandra, ginseng and others);
bromine preparations with caffeine;
B vitamins;
according to indications - tranquilizers.

With prolonged exposure to radioactive radiation on the body, pathological process, which can lead to death.

The complex disease is especially dangerous for people with weakened immune systems, adolescents, pregnant women and children. When exposed to radionuclides, disturbances are observed in the central nervous system. In case of illness it is noted increased risk development of cancer.

Causes of radiation sickness

Radiation doses that cause radiation sickness are 1-10 Gray. Radioactive components penetrate into healthy body person through the following ways:

mucous membranes of the nose, mouth and eyes;
contaminated food;
lungs when inhaling air;
inhalation procedures;
skin;
water.

Exposure through injection is possible. Radionuclides cause changes in human organs, which can lead to unpleasant consequences. Harmful components cause an oxidative reaction in human tissues.

Factors and forms

There are such factors that provoke the disease:

penetration of radionuclides;
short but strong impact per person radiation waves;
constant exposure to x-rays.

Medical specialists note two forms of radiation sickness: acute and chronic. The acute form occurs with a single short-term irradiation of a person at a dose of 1 Gy. Chronic radiation sickness develops in humans with prolonged exposure to radiation. This occurs when the total radiation dose exceeds 0.7 Gy.

Symptoms of radiation sickness

If radiation hits a small area of the skin, then symptoms of radiation sickness will only appear in a certain area. This impact should not be ignored, since the pathology leads to serious complications. Because of this, the immune system weakens, the function antioxidant protection weakens. The affected cells begin to die, and the normal functioning of many body systems is disrupted:

hematopoietic;
central nervous system;
endocrine;
gastrointestinal tract;
cardiovascular.

The rate at which symptoms develop directly depends on the doses of radiation a person receives. When exposed to radiation, a person is affected high temperature, exposure to light and mechanical energy, especially if he was at the center of the explosion. Possible chemical burns.

Degrees

Different doses of pathology are accompanied by their own symptoms. In radiation medicine, 4 degrees of human damage from radiation are described. Dependence of radiation sickness doses and degree (unit of measurement - Gray):

first – 1-2 Gy;
second – 2-4 Gy;
third – 4-6 Gy;
fourth – from 6 Gy.

Doses and degrees (unit Sieverts)

If a person receives radiation in an amount less than 1 Gy, then this is radiation injury. Each degree is characterized by its own symptoms. TO common features irradiation include disturbances in the following systems:

gastrointestinal;
cardiovascular;
hematopoietic.

First degree

The first signs of radiation sickness are nausea. Then, the person affected by radiation begins to vomit, and the mouth feels bitter or dry. Possible tremor of the limbs, increased heart rate.

If the source of radiation is eliminated at this stage, then the listed symptoms will disappear after rehabilitation therapy. This description is suitable for damage by radionuclides in the 1st degree.

Second degree

Symptoms of second degree radiation include:

skin rashes;
movement disorder;
decreased reflexes;
eye spasm;
baldness;
drop in blood pressure;
signs characteristic of the first degree.

If second-degree treatment is not performed, the pathology develops into a severe form.

Third degree

Signs of third degree damage to the human body by radionuclides depend on the importance of the affected organs and their functions. All of the listed symptoms are summed up and appear in the patient at the third stage of the disease.

Such radiation affects the body with the following symptoms:

exacerbation of infectious diseases;
decreased immunity;
complete intoxication;
severe bleeding (hemorrhagic syndrome).

Fourth degree

Acute radiation sickness occurs at the fourth degree of exposure. In addition to the appearance of insurmountable weakness in a person, other symptoms of acute radiation sickness appear:

Temperature increase.
Severe decrease in blood pressure.
Pronounced tachycardia.
The appearance of necrotic ulcers in the digestive system.

The pathological process causes swelling of the membranes of the brain and gums. Hemorrhages are observed on the mucous membranes of the urinary and respiratory tract, organs of the gastrointestinal tract, and heart muscle.

Consequences of radiation sickness

Complications of radiation pathology appear in those who have suffered it. After the disease, patients are considered disabled for approximately 6 months. Rehabilitation of the body after light impact radionuclides is 3 months.

The consequences of radiation include:

Exacerbation of chronic infectious diseases.
Death.
Anemia, leukemia and other blood pathologies
Development of neoplasms of a malignant nature.
Cloudiness of the lens and vitreous eyes.
Genetically determined anomalies transmitted from generation to generation.
Disruption of the reproductive system organs.
Various dystrophic changes.

Diagnosis of radiation injury

You can speed up the recovery process and reduce the risk of complications if you receive prompt medical attention if you suspect exposure to radiation. Need to know

Radiation sickness

What is Radiation sickness -

Pathogenesis (what happens?) during Radiation sickness:

Radiation sickness is divided into acute (subacute) and chronic forms depending on the time distribution and absolute value of radiation exposure, which determine the dynamics of developing changes. The uniqueness of the mechanism of development of acute and chronic radiation sickness excludes the transition of one form to another. The conventional limit that delimits acute or chronic forms is the accumulation over a short period of time (from 1 hour to 1-3 days) of a total tissue dose equivalent to that from exposure to 1 Gy of external penetrating radiation.

The development of the leading clinical syndromes of acute radiation sickness depends on external radiation doses, which determine the variety of lesions observed. In addition, the type of radiation also plays an important role, each of which has certain characteristics, which are associated with differences in their damaging effect on organs and systems. Thus, a-radiation is characterized by a high ionization density and low penetrating ability, and therefore these sources cause a damaging effect limited in space.

When irradiated in doses from 10 to 50 Gy, symptoms of damage to the gastrointestinal tract with rejection of the small intestinal mucosa, leading to death within 2 weeks, come to the fore in the mechanism of development of the main manifestations of the radiation-induced clinical picture of the disease.

Damage to the organs of the gastrointestinal tract, various structures of both the brain and spinal cord, as well as the hematopoietic organs is characteristic of exposure to the above doses of radiation. The severity of such changes and the speed of development of disorders depend on the quantitative parameters of exposure.

Symptoms of Radiation Sickness:

If acute radiation sickness occurs in a typical form, its clinical picture can be divided into four degrees of severity. Symptoms characteristic of each degree of acute radiation sickness are determined by the dose of radioactive radiation that the patient received:

1) mild degree occurs when irradiated at a dose of 1 to 2 Gy;

2) moderate severity - the radiation dose ranges from 2 to 4 Gy;

3) severe - the radiation dose ranges from 4 to 6 Gy;

4) extremely severe degree occurs when irradiated at a dose exceeding 6 Gy.

If the patient received a dose of radioactive radiation in a dose of less than 1 Gy, then we have to talk about the so-called radiation injury, which occurs without any obvious symptoms of the disease.

Severe disease is accompanied by recovery processes that last a long time over 1-2 years. In cases where any changes remain that become persistent, in the future we should talk about the consequences of acute radiation sickness, and not about the transition of the acute form of the disease to the chronic one.

Patients have some variability in pulse and blood pressure with a tendency to decrease, and are characterized by a uniform general decrease in muscle tone, trembling of the fingers, and decreased tendon reflexes. Changes

electroencephalograms indicate moderate diffuse inhibition of the cerebral cortex.

In phase I of the disease, at radiation doses exceeding 3 Gy, some biochemical changes are detected: a decrease in serum albumin, an increase in blood glucose levels with a change in the sugar curve. In more severe cases, moderate transient bilirubinemia is detected, thereby indicating metabolic disorders in the liver, in particular a decrease in the absorption of amino acids and increased protein breakdown.

In phase II, neurological symptoms become more pronounced (impaired movements, coordination, involuntary trembling of the eyeballs, organic movements, symptoms of mild pyramidal insufficiency, decreased reflexes). The EEG shows the appearance of slow waves and their synchronization with the pulse rhythm.

The results of biochemical blood tests indicate a slight decrease in the albumin fraction of serum proteins, normalization of blood sugar and serum bilirubin levels.

In phase III, which occurs with pronounced clinical symptoms, the timing of onset and the degree of intensity of individual clinical syndromes depend on the dose of ionizing radiation; The duration of the phase ranges from 7 to 20 days.

Damage to the blood system is dominant in this phase of the disease. Along with this, immunosuppression, hemorrhagic syndrome, the development of infections and autointoxication occur.

By the end of the latent phase of the disease, the condition of the patients deteriorates significantly, resembling a septic state with characteristic symptoms: increasing general weakness, rapid pulse, fever, low blood pressure. Pronounced swelling and bleeding of the gums. In addition, the mucous membranes of the oral cavity and gastrointestinal tract are affected, which manifests itself in the appearance of a large number of necrotic ulcers. Ulcerative stomatitis occurs when irradiated in doses of more than 1 Gy on the oral mucosa and lasts about 1-1.5 months. The mucous membrane almost always recovers completely. With high doses of radiation, severe inflammation of the small intestine develops, characterized by diarrhea, fever, bloating and pain in the ileal region. At the beginning of the 2nd month of the disease, radiation inflammation of the stomach and esophagus may occur. Infections most often manifest themselves in the form of ulcerative-erosive sore throats and pneumonia. The leading role in their development is played by autoinfection, which acquires pathogenic significance against the background of a pronounced inhibition of hematopoiesis and suppression of the immunobiological reactivity of the body.

Neurological symptoms are a consequence of general intoxication, infection, and anemia. Increasing general lethargy, adynamia, darkening of consciousness, meningeal symptoms, increased tendon reflexes, and decreased muscle tone are noted. Usually, signs of increasing edema of the brain and its membranes are detected. Slow pathological waves appear on the EEG.

Diagnosis of Radiation Sickness:

The beginning of regeneration is confirmed by an increase in the number of leukocytes, the appearance of reticulocytes in the hemogram, as well as a sharp shift in the leukocyte formula to the left.

The bone marrow picture at lethal doses of radiation remains devastated throughout phase III of the disease. At lower doses, after a 7-12-day period of aplasia, blast elements appear in the myelogram, and then the number of cells of all generations increases. With moderate severity of the process, signs of hematopoietic repair are detected in the bone marrow from the first days of phase III against the background of a sharp decrease in the total number of myelokaryocytes.

Biochemical studies reveal hypoproteinemia, hypoalbuminemia, a slight increase in the level of residual nitrogen, and a decrease in the amount of blood chlorides.

Phase IV - the immediate recovery phase - begins with normalization

temperature, improvement of the general condition of patients.

If there has been a severe course of acute radiation sickness, patients will experience a long-term pastiness of the face and limbs. The remaining hair becomes dull, dry and brittle; new hair growth at the site of baldness resumes 3-4 months after irradiation.

Pulse and blood pressure normalize, sometimes moderate hypotension remains for a long time.

For some time, hand tremors, static incoordination, a tendency to increase tendon and periostenal reflexes, and some unstable focal neurological symptoms have been noted. The latter are regarded as a result of functional disorders of cerebral circulation, as well as neuronal exhaustion against the background of general asthenia.

There is a gradual recovery of peripheral blood parameters. The number of leukocytes and platelets increases and by the end of the 2nd month reaches the lower limit of normal. In the leukocyte formula there is a sharp shift to the left to promyelocytes and myeloblasts, the content of band forms reaches 15-25%. The number of monocytes is normalized. By the end of the 2-3rd month of the disease, reticulocytosis is detected.

Until the 5-6th week of the disease, anemia continues to increase with phenomena of anisocytosis of erythrocytes due to macroforms.

V persons exposed to radiation, in the long term, leukemia develops 5-7 times
more often.

Severe neutropenia in phase III of the disease is a reflection of the devastation of the bone marrow and the almost complete absence of all granulocytic elements in it.

At approximately the same time, a maximum decrease in the number of platelets in the peripheral blood is observed.

Treatment of Radiation Sickness:

In case of irradiation at a dose of 2.5 Gy or higher, fatal outcomes are possible. A dose of 4 ± 1 Gy is approximately considered the average lethal dose for humans, although in cases of irradiation at a dose of 5-10 Gy, clinical recovery with proper and timely treatment is still possible. When irradiated at a dose of more than 6 Gy, the number of survivors is practically reduced to zero.

In case of severe acute radiation sickness, during the first 2-3 days after irradiation, the doctor carries out detoxification therapy (for example, polyglucin). To combat collapse, well-known drugs are used - cardamine, mesaton, norepinephrine, as well as kinin inhibitors: trasylol or contrical.

Prevention and treatment of infectious complications

The system of measures aimed at preventing external and internal infections uses isolators of various types with a supply of sterile air, sterile medical materials, care items and food. The skin and visible mucous membranes are treated with antiseptics; non-absorbable antibiotics (gentamicin, kanamycin, neomycin, polymyxin-M, ristomycin) are used to suppress the activity of intestinal flora. At the same time, large doses of nystatin (5 million units or more) are prescribed orally. In cases where the level of leukocytes decreases below 1000 per 1 mm3, prophylactic use of antibiotics is advisable.

When treating infectious complications, large doses of intravenously administered broad-spectrum antibacterial drugs (gentamicin, ceporin, kanamycin, carbenicillin, oxacillin, methicillin, lincomycin) are prescribed. When a generalized fungal infection occurs, amphotericin B is used.

It is advisable to enhance antibacterial therapy with biological drugs of targeted action (antistaphylococcal plasma and γ-globulin, antipseudomonal plasma, hyperimmune plasma against Escherichia coli).

If no positive effect is observed within 2 days, the doctor changes antibiotics and then prescribes them taking into account the results of bacteriological cultures of blood, urine, feces, sputum, smears from the oral mucosa, as well as external local infectious foci, which are performed on the day of admission and beyond. -in one day. In cases of viral infection, acyclovir can be used with effect.

The fight against bleeding includes the use of general and local hemostatic agents. In many cases, agents that strengthen the vascular wall (dicinone, steroid hormones, ascorbic acid, rutin) and increase blood clotting (E-AKK, fibrinogen) are recommended.

In the vast majority of cases, thrombocytopenic bleeding can be stopped by transfusion of an adequate amount of freshly prepared donor platelets obtained by thrombocytopenia. Platelet transfusions are indicated in cases of deep thrombocytopenia (less than 20 109/l), occurring with hemorrhages on the skin of the face, upper half of the body, in the fundus, with local visceral bleeding.

Anemic syndrome rarely develops in acute radiation sickness. Transfusions of red blood cells are prescribed only when the hemoglobin level decreases below 80 g/l.

Transfusions of freshly prepared red blood cells, washed or thawed red blood cells are used. In rare cases, there may be a need for individual selection not only for the ABO system and Rh factor, but also for other erythrocyte antigens (Kell, Duffy, Kidd).

Treatment of ulcerative-necrotic lesions of the mucous membranes of the gastrointestinal tract.

In the prevention of ulcerative-necrotic stomatitis, rinsing the mouth after meals (with a 2% soda solution or a 0.5% novocaine solution), as well as antiseptics (1% hydrogen peroxide, 1% solution 1) are important: 5000 furatsilin; 0.1% gramicidin, 10% water-alcohol emulsion of propolis, lysozyme). In cases of candidiasis, nystatin and levorin are used.

One of the severe complications of agranulocytosis and direct exposure to radiation is necrotizing enteropathy. The use of biseptol or antibiotics that sterilize the gastrointestinal tract helps reduce clinical manifestations or even prevent its development. If necrotic enteropathy occurs, the patient is prescribed complete fasting. In this case, only the intake of boiled water and drugs that relieve diarrhea (dermatol, bismuth, chalk) is allowed. In severe cases of diarrhea, parenteral nutrition is used.

Bone marrow transplantation

Allogeneic histocompatible bone marrow transplantation is indicated only in cases characterized by irreversible depression of hematopoiesis and profound suppression of immunological reactivity.

Consequently, this method has limited capabilities, since there are still no sufficiently effective measures to overcome tissue incompatibility reactions.

The primary reaction that occurs after radiation exposure at a dose of more than 6 Gy is the appearance of nausea (vomiting), chills against a background of elevated temperature, a tendency to hypotension, sensations of dry mucous membranes of the nose and lips, and a bluish complexion, especially the lips and neck. The general irradiation procedure is carried out in a specially equipped irradiator under constant visual observation of the patient using television cameras in the conditions of two-way communication. If necessary, the number of breaks can be increased.

Among other symptoms that naturally arise as a result of “therapeutic” full irradiation, it should be noted inflammation parotid gland in the first hours after irradiation, redness of the skin, dryness and swelling of the mucous membranes of the nasal passages, sensations of pain in eyeballs, conjunctivitis.

The most serious complication is hematological syndrome. Usually, this syndrome develops in the first 8 days after the patient receives a dose of radiation.

Which doctors should you contact if you have radiation sickness:

Hematologist

Therapist

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Other diseases from the group Diseases of the blood, hematopoietic organs and certain disorders involving the immune mechanism:

B12 deficiency anemia

Anemia caused by impaired synthesis and utilization of porphyrins

Anemia caused by a violation of the structure of globin chains

Anemia characterized by the carriage of pathologically unstable hemoglobins

Fanconi anemia

Anemia associated with lead poisoning

Aplastic anemia

Autoimmune hemolytic anemia

Autoimmune hemolytic anemia with incomplete heat agglutinins

Autoimmune hemolytic anemia with complete cold agglutinins

Autoimmune hemolytic anemia with warm hemolysins

Heavy chain diseases

Werlhof's disease

von Willebrand disease

Di Guglielmo's disease

Christmas disease

Marchiafava-Miceli disease

Randu-Osler disease

Alpha heavy chain disease

Gamma heavy chain disease

Henoch-Schönlein disease

Extramedullary lesions

Hairy cell leukemia

Hemoblastoses

Hemolytic-uremic syndrome

Hemolytic anemia associated with vitamin E deficiency

Hemolytic anemia associated with glucose-6-phosphate dehydrogenase (G-6-PDH) deficiency

Hemolytic disease of the fetus and newborn

Hemolytic anemia associated with mechanical damage to red blood cells

Hemorrhagic disease of the newborn

Malignant histiocytosis

Histological classification of lymphogranulomatosis

DIC syndrome

Deficiency of K-vitamin-dependent factors

Factor I deficiency

Factor II deficiency

Factor V deficiency

Factor VII deficiency

Factor XI deficiency

Factor XII deficiency

Factor XIII deficiency

Iron-deficiency anemia

Patterns of tumor progression

Immune hemolytic anemias

Bedbug origin of hemoblastoses

Leukopenia and agranulocytosis

Lymphosarcoma

Lymphocytoma of the skin (Caesary disease)

Lymphocytoma of the lymph node

Lymphocytoma of the spleen

March hemoglobinuria

Mastocytosis (mast cell leukemia)

Megakaryoblastic leukemia

The mechanism of inhibition of normal hematopoiesis in hemoblastoses

Obstructive jaundice

Myeloid sarcoma (chloroma, granulocytic sarcoma)

Myeloma

Myelofibrosis

Disorders of coagulation hemostasis