About radiation sickness. Radiation sickness - causes, symptoms, diagnosis and treatment of radiation sickness

Radiation sickness is a pathological condition of a person, which is caused by a systematic effect on the body of radioactive irradiation. The clinical picture appears if the radiation dose exceeds 100 rad (1 Gy). If the dose is less than indicated, then we can talk about the asymptomatic course of radiation sickness.

Etiology

Etiological factors that can provoke the development of radiation sickness are the following:

short, but intense impact on the body of radiation waves;
systematic exposure of a person to X-ray waves;
ingestion of radioactive compounds.

Irradiation is possible even in the case of a slight contact with the skin of radioactive rays. In this case, signs of the disease appear on the affected area of \u200b\u200bthe skin. If at this stage the necessary medical care is not provided and treatment is not started, the disease can give serious complications.

Pathogenesis

The pathogenesis of radiation sickness is quite simple. Radiation that penetrates human tissue is the cause of the formation of an oxidative reaction. Against the background of this process, the antioxidant defense system is significantly weakened and cannot fully perform its functions. As a result, the affected cells die. Such a mechanism for the development of the disease leads to disruption of the normal functioning of such systems:

central nervous system;
cardiovascular;
endocrine;
hematopoietic.

The higher the dose of radiation received by a person, the faster the clinical picture will develop. In addition, it is worth noting that if a person is at this time near the explosion or at its epicenter, the body will be additionally affected:

exposure to mechanical and light energy;
heat.

Therefore, in addition to violations in the functioning of systems, chemical burns are possible.

The degree of development of the disease and forms

There are two forms of radiation sickness - chronic and acute. Chronic radiation sickness may show no signs at all until a certain point. Acute radiation sickness has a well-defined clinical picture.

In modern medicine, there are four degrees of radiation sickness:

mild (irradiation up to 2 Gy);
medium (from 2 to 4 Gy);
heavy (from 4 to 6 Gy);
very heavy (more than 6 Gy).

The last two stages of the disease have already irreversible processes. Not an exception - a lethal outcome.

General symptoms

Chronic radiation sickness is asymptomatic in the initial stages. The clinical picture appears somewhat later.

Acute radiation sickness manifests itself in the form of such symptoms:

severe headache, sometimes accompanied by dizziness;
nausea and vomiting;
nose bleed;
general malaise, weakness;
a blood test shows an increased content of and;
in some places the skin turns red and begins to itch.

The period of manifestation of such symptoms lasts no more than one week. As the disease develops, the clinical picture is supplemented by the following symptoms:

low body temperature;
Strong headache;
cramps in the lower extremities;
loss of appetite, nausea;
unstable blood pressure.

With the last degree of development of acute radiation sickness, the general condition of the patient worsens significantly, the clinical picture is supplemented by the following symptoms:

hair loss, thinning of the skin and nail plates;
disruption of the genitourinary system (women have menstrual irregularities, men have problems with potency);
the formation of ulcers on the mucous membranes of the mouth, intestines and stomach;
fever, for no apparent reason;
severely weakened immunity.

The last period of development of the acute form of the disease begins approximately 4 weeks after exposure. Restoring the functionality of the systems is possible if the correct treatment is started. The most difficult thing is to restore the functioning of the genitourinary system.

It is noteworthy that in the second stage of the development of acute radiation sickness, the symptoms may partially disappear, the patient's condition may improve significantly. But this does not say anything about the recovery of a person.

After radiation sickness, the likelihood of developing complications is high. Most often this is due to the work of the gastrointestinal tract, the cardiovascular system.

Classification of the disease

In modern medicine, types of radiation sickness are distinguished according to the time and nature of localization.

According to the time of irradiation, the following forms are distinguished:

single;
prolonged;
chronic.

According to the nature of localization:

local or general form;
uniform or uneven.

As medical practice shows, the acute stage of the development of the disease is accompanied by lesions in all areas of the skin and at all levels - tissue, molecular, organ. Almost always there is swelling of the brain. If the patient is not given the correct treatment, then a lethal outcome is not ruled out.

Diagnostics

If you have the above symptoms, you should immediately contact an oncologist or therapist. After a personal examination and clarification of symptoms, a general history, laboratory and instrumental methods of research are carried out.

The laboratory research program includes the following:

blood clotting testing.

As for instrumental research methods, the standard program includes such analyzes:

puncture biopsy of the bone marrow;
electroencephalography.

Only on the basis of all the tests passed, it is possible to accurately diagnose, identify the degree of development of the disease and prescribe the correct course of treatment.

It should be noted that the diagnostic program can be supplemented by other research methods. It all depends on the degree of development of radiation sickness and what systems of the human body are involved in the pathological process.

Treatment

Radiation sickness of a person at an early stage is treated quite well. But it should be understood that such an effect of radiation on the human body does not pass without a trace. After completing the course of treatment, the patient needs a long period of rehabilitation.

Drug treatment involves taking such drugs:

antihistamines;
antibiotics;
for general strengthening of the immune system;
vitamin complexes.

If the patient is diagnosed with the third stage of the disease, then in addition to the above drugs, antihemorrhagic agents are prescribed. Blood transfusion is also mandatory.

In addition, at any stage of the development of the disease, physiotherapy procedures are used - oxygen masks and exercise therapy. It is worth noting that during this period it is very important for the patient to eat right. Proper treatment of radiation sickness gives positive results and significantly reduces the risk of serious diseases.

Nutrition for radiation sickness

During the period of treatment and medication, the patient should eat right:

consume the optimal amount of liquid - at least 2 liters per day (including juices and tea);
do not drink while eating;
steamed food is preferred;
the consumption of fatty, spicy, salty foods is minimized.

You need to eat in small portions, but quite often - at least 5 times a day. Smoking and alcohol consumption are naturally excluded.

Possible Complications

Depending on the nature of the development of the disease and the general health of the patient, radiation sickness can cause complications. The most common side effects of radiation sickness are:

ophthalmic diseases;
malignant tumors that can cause severe cancer;
complete baldness of the human skin;
disorders in hematopoiesis.

Such complications can be avoided at least partially if the disease is diagnosed at an early stage and the correct treatment is started. Therefore, at the first symptoms, you should immediately seek medical help.

Prevention

Prevention of radiation sickness is especially important for those people who live in a zone of high radiation. But such events are also important for residents of other countries.

For people who are at risk, prevention is as follows:

taking vitamins of group B6, P, C;
hormonal anabolic drugs;
drugs to strengthen the immune system.

But you need to consume such drugs strictly according to the doctor's prescription.

General prevention includes taking radioprotectors, vitamins and general strengthening of immunity. Such measures minimize the risk of developing a pathological process. If a person has the above signs of illness, you should immediately seek medical help. Procrastination or self-medication can not only accelerate the development of the disease, but also cause the development of serious complications.

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- a complex of general and local reactive changes caused by the impact of high doses of ionizing radiation on cells, tissues and body environments. Radiation sickness occurs with phenomena of hemorrhagic diathesis, neurological symptoms, hemodynamic disorders, a tendency to infectious complications, gastrointestinal and skin lesions. Diagnosis is based on the results of dosimetric monitoring, characteristic changes in the hemogram, biochemical blood tests, myelogram. In the acute stage of radiation sickness, detoxification, blood transfusions, antibiotic therapy, and symptomatic therapy are carried out.

General information

Radiation sickness is a common disease caused by exposure to the body of radioactive radiation in a range exceeding the maximum allowable doses. It occurs with damage to the hematopoietic, nervous, digestive, skin, endocrine and other systems. Throughout life, a person is constantly exposed to small doses of ionizing radiation emanating from both external (natural and man-made) and internal sources that enter the body during breathing, consumption of water and food and accumulate in tissues. Thus, under a normal radiation background, taking into account the above factors, the total dose of ionizing radiation usually does not exceed 1-3 mSv (mGy) / year and is considered safe for the population. According to the conclusion of the International Commission on Radiological Protection, if the exposure threshold is exceeded by more than 1.5 Sv / year or a single dose of 0.5 Sv is received, radiation sickness can develop.

Causes of radiation sickness

Radiation injuries can occur as a result of a single (or short-term) exposure to high intensity or prolonged exposure to low doses of radiation. A high-intensity damaging effect is typical for man-made disasters in the nuclear power industry, testing or use of nuclear weapons, total irradiation in oncology, hematology, rheumatology, etc. Chronic radiation sickness can develop in medical personnel of radiation diagnostics and therapy departments (radiologists, radiologists), patients exposed to frequent x-ray and radionuclide studies.

The damaging factors can be alpha and beta particles, gamma rays, neutrons, x-rays; simultaneous exposure to different types of radiation energy is possible - the so-called mixed irradiation. At the same time, the neutron flux, X-ray and gamma radiation can cause radiation sickness when exposed to external factors, while alpha and beta particles cause damage only when they enter the body through the respiratory or digestive tract, damaged skin and mucous membranes.

Radiation sickness is the result of damaging effects occurring at the molecular and cellular level. As a result of complex biochemical processes, products of pathological fat, carbohydrate, nitrogen, water-salt metabolism appear in the blood, causing radiation toxemia. The damaging effects primarily affect actively dividing cells of the bone marrow, lymphoid tissue, endocrine glands, intestinal and skin epithelium, and neurons. This causes the development of bone marrow, intestinal, toxemic, hemorrhagic, cerebral and other syndromes that make up the pathogenesis of radiation sickness.

The peculiarity of radiation injury is the absence at the moment of direct exposure to thermal, pain and other sensations, the presence of a latent period preceding the development of a detailed picture of radiation sickness.

Classification

The classification of radiation sickness is based on the criteria for the time of injury and the dose of absorbed radiation. With a single massive exposure to ionizing radiation, acute radiation sickness develops, with prolonged, repeated in relatively small doses, chronic radiation sickness develops. The severity and clinical form of acute radiation injury are determined by the radiation dose:

radiation injury occurs with single-stage / short-term exposure to a dose of less than 1 Gy; pathological changes are reversible.

Bone marrow form(typical) develops with single-stage / short-term exposure to a dose of 1-6 Gy. Lethality is 50%. It has four degrees:

1 (light) - 1-2 Gy
2 (medium) - 2-4 Gy
3 (heavy) - 4-6 Gy
4 (extremely severe, transitional) - 6-10 Gr

Gastrointestinal form is the result of a single-stage / short-term exposure to a dose of 10-20 Gy. It proceeds with severe enteritis, bleeding from the gastrointestinal tract, fever, infectious and septic complications.

Vascular (toxemic) form Manifests with simultaneous/short-term irradiation with a dose of 20-80 Gy. It is characterized by severe intoxication and hemodynamic disturbances.

cerebral form develops with simultaneous / short-term exposure to a dose of more than 80 Gy. Lethal outcome occurs 1-3 days after irradiation due to cerebral edema.

The course of a typical (bone marrow) form of acute radiation sickness goes through phase IV:

I- phase of primary general reactivity - develops in the first minutes and hours after radiation exposure. Accompanied by malaise, nausea, vomiting, arterial hypotension, etc.
II- latent phase - the primary reaction is replaced by an imaginary clinical well-being with an improvement in the subjective state. It starts from 3-4 days and lasts up to 1 month.
III- phase of extended symptoms of radiation sickness; proceeds with hemorrhagic, anemic, intestinal, infectious and other syndromes.
IV- recovery phase.

Chronic radiation sickness in its development goes through 3 periods: formation, recovery and consequences (outcomes, complications). The period of formation of pathological changes lasts 1-3 years. In this phase, a clinical syndrome characteristic of radiation injury develops, the severity of which can vary from mild to extremely severe. The recovery period usually begins 1-3 years after a significant decrease in the intensity or complete cessation of radiation exposure. The outcome of chronic radiation sickness may be recovery, incomplete recovery, stabilization of the changes or their progression.

Symptoms of radiation sickness

Acute radiation sickness

In typical cases, radiation sickness occurs in the bone marrow form. In the first minutes and hours after receiving a high dose of radiation, in the first phase of radiation sickness, the victim develops weakness, drowsiness, nausea and vomiting, dryness or bitterness in the mouth, and headache. With simultaneous exposure to a dose of more than 10 Gy, fever, diarrhea, arterial hypotension with loss of consciousness may develop. Of the local manifestations, transient skin erythema with a bluish tinge may be noted. On the part of the peripheral blood, early changes are characterized by reactive leukocytosis, which on the second day is replaced by leukopenia and lymphopenia. In the myelogram, the absence of young cell forms is determined.

In the phase of apparent clinical well-being, the signs of the primary reaction disappear, and the victim's well-being improves. However, with an objective diagnosis, the lability of blood pressure and pulse, a decrease in reflexes, impaired coordination, and the appearance of slow rhythms according to EEG are determined. Baldness begins and progresses 12-17 days after radiation injury. Leukopenia, thrombocytopenia, reticulocytopenia increase in the blood. The second phase of acute radiation sickness can last from 2 to 4 weeks. At an irradiation dose of more than 10 Gy, the first phase can immediately pass into the third.

In the phase of severe clinical symptoms of acute radiation sickness, intoxication, hemorrhagic, anemic, infectious, skin, intestinal, and neurological syndromes develop. With the beginning of the third phase of radiation sickness, the condition of the victim worsens. At the same time, weakness, fever, arterial hypotension again increase. Against the background of deep thrombocytopenia, hemorrhagic manifestations develop, including bleeding gums, nosebleeds, gastrointestinal bleeding, hemorrhages in the central nervous system, etc. The result of damage to the mucous membranes is the occurrence of ulcerative necrotic gingivitis, stomatitis, pharyngitis, gastroenteritis. Infectious complications of radiation sickness most often include tonsillitis, pneumonia, and lung abscesses.

With high-dose radiation, radiation dermatitis develops. In this case, primary erythema is formed on the skin of the neck, elbows, axillary and inguinal regions, which is replaced by skin edema with the formation of blisters. In favorable cases, radiation dermatitis resolves with the formation of pigmentation, scarring, and thickening of the subcutaneous tissue. With the interest of the vessels, radiation ulcers and skin necrosis occur. Hair loss is common: there is epilation of hair on the head, chest, pubis, loss of eyelashes and eyebrows. In acute radiation sickness, there is a deep inhibition of the function of the endocrine glands, mainly the thyroid gland, gonads, and adrenal glands. In the late period of radiation sickness, an increase in the development of thyroid cancer was noted.

The defeat of the gastrointestinal tract can occur in the form of radiation esophagitis, gastritis, enteritis, colitis, hepatitis. At the same time, nausea, vomiting, pain in various parts of the abdomen, diarrhea, tenesmus, blood in the feces, jaundice are observed. The neurological syndrome accompanying the course of radiation sickness is manifested by increasing adynamia, meningeal symptoms, confusion, decreased muscle tone, and increased tendon reflexes.

In the recovery phase, the state of health gradually improves, and impaired functions partially normalize, however, anemia and asthenovegetative syndrome persist for a long time in patients. Complications and residual lesions of acute radiation sickness may include the development of cataracts, liver cirrhosis, infertility, neuroses, leukemia, malignant tumors of various localizations.

chronic radiation sickness

In the chronic form of radiation sickness, pathological effects unfold more slowly. Leading are neurological, cardiovascular, endocrine, gastrointestinal, metabolic, hematological disorders.

A mild degree of chronic radiation sickness is characterized by nonspecific and functionally reversible changes. Patients feel weakness, decreased performance, headaches, sleep disturbances, instability of the emotional background. Among the constant signs are a decrease in appetite, dyspeptic syndrome, chronic gastritis with reduced secretion, biliary dyskinesia. Endocrine dysfunction in radiation sickness is expressed in a decrease in libido, menstrual irregularities in women, and impotence in men. Hematological changes are unstable and not pronounced. The course of a mild degree of chronic radiation sickness is favorable, recovery without consequences is possible.

With an average degree of radiation injury, more pronounced vegetative-vascular disorders and asthenic manifestations are noted. There are dizziness, increased emotional lability and excitability, weakening of memory, attacks of loss of consciousness are possible. Trophic disorders join: alopecia, dermatitis, nail deformities. Cardiovascular disorders are represented by persistent arterial hypotension, paroxysmal tachycardia. For the II degree of severity of chronic radiation sickness, hemorrhagic phenomena are characteristic: multiple petechiae and ecchymosis, recurrent nasal and gingival bleeding. Typical hematological changes are leukopenia, thrombocytopenia; in the bone marrow - hypoplasia of all hematopoietic germs. All changes are permanent.

A severe degree of radiation sickness is characterized by dystrophic changes in tissues and organs that are not compensated by the regenerative capabilities of the body. Clinical symptoms are of progressive development, intoxication syndrome and infectious complications, including sepsis, are additionally added. There is a sharp asthenia, persistent headaches, insomnia, multiple hemorrhages and repeated bleeding, loosening and loss of teeth, ulcerative necrotic changes in mucous membranes, total alopecia. Changes in peripheral blood, biochemical parameters, bone marrow are deeply pronounced. With IV, an extremely severe degree of chronic radiation sickness, the progression of pathological changes occurs steadily and quickly, leading to an inevitable death.

Diagnosis of radiation sickness

The development of radiation sickness can be assumed on the basis of the picture of the primary reaction, the chronology of the development of clinical symptoms. Establishing the fact of radiation damaging effects and dosimetric monitoring data facilitates diagnosis.

The severity and staging of the lesion can be determined by changes in the pattern of peripheral blood. With radiation sickness, there is an increase in leukopenia, anemia, thrombocytopenia, reticulocytopenia, and an increase in ESR. When analyzing biochemical parameters in the blood, hypoproteinemia, hypoalbuminemia, and electrolyte disturbances are detected. The myelogram revealed signs of severe hematopoiesis suppression. With a favorable course of radiation sickness in the recovery phase, the reverse development of hematological changes begins.

Of auxiliary importance are other laboratory diagnostic data (microscopy of scrapings of skin and mucous ulcers, blood culture for sterility), instrumental studies (EEG, electrocardiography, ultrasound of the abdominal cavity, small pelvis with saline, plasma-substituting and saline solutions), forced diuresis. With the phenomena of necrotic enteropathy, hunger, parenteral nutrition, treatment of the oral mucosa with antiseptics are prescribed.

In order to combat hemorrhagic syndrome, blood transfusions of platelet and erythrocyte mass are carried out. With the development of DIC, fresh frozen plasma is transfused,. In order to prevent infectious complications, antibiotic therapy is prescribed. A severe form of radiation sickness, accompanied by bone marrow aplasia, is an indication for bone marrow transplantation. In chronic radiation sickness, therapy is mainly symptomatic.

Forecast and prevention

The prognosis of radiation sickness is directly related to the massiveness of the received dose of radiation and the time of the damaging effect. Patients who survive the critical period of 12 weeks after irradiation have a chance for a favorable prognosis. However, even with non-lethal radiation injury, the victims may subsequently develop hemoblastoses, malignant neoplasms of various localization, and various genetic abnormalities may be detected in the offspring.

In order to prevent radiation sickness, persons in the zone of radio emission should use personal radiation protection and control equipment, radioprotective drugs that reduce the radiosensitivity of the body. Persons in contact with sources of ionizing radiation must undergo periodic medical examinations with mandatory hemogram control.

When a human body is exposed to ionizing rays in large doses, radiation sickness can occur - damage to cellular structures, tissues and liquid media, occurring in an acute or chronic form. In our time, an acute illness is relatively rare - this is possible only in case of accidents and a single high-power external exposure. Chronic radiation pathology is caused by prolonged exposure of the body to radiation flux in small doses, which, however, exceed the maximum allowable amount. In this case, almost all organs and systems are affected, so the clinical picture of the disease is diverse and not always the same.

ICD code 10

J 70.0 - Acute pulmonary pathology provoked by radiation.
J 70.1 - Chronic and other pulmonary pathology provoked by radiation.
K 52.0 - Radiation form of gastroenteritis and colitis.
K 62.7 - Radiation form of proctitis.
M 96.2 - Post-radiation form of kyphosis.
M 96.5 - Post-radiation form of scoliosis.
L 58 - Radiation dermatitis.
L 59 - Other dermatological diseases associated with exposure to radiation.
T 66 - Unspecified pathologies associated with radiation.

ICD-10 code

Z57.1 Occupational exposure to radiation

Causes of radiation sickness

The acute form of radiation sickness in humans occurs with a short (several minutes, hours, or 1-2 days) irradiation of the body in a dosage above 1 g (100 Rad.). Such exposure can be obtained while in the area of radiation exposure or during radioactive fallout, in case of improper work with strong radiation sources, in accidents that occur with the release of radiation, as well as in the use of radiation therapy for therapeutic purposes.

In addition, the causes of radiation sickness can be various types of radiation and radiation that are in the atmosphere, in food consumed, in water. The ingress of radioactive components into the body can occur during breathing, when eating. Substances can be absorbed through the pores of the skin, penetrate into the eyes, etc.

An important role in the appearance of the disease is played by biogeochemical anomalies, environmental pollution due to a nuclear explosion, leakage of nuclear waste, etc. During a nuclear explosion, the atmosphere is saturated as a result of the release of radioactive substances into the air that did not enter into a chain reaction, causing the appearance of new isotopes. A clearly marked severe course of radiation injury is observed after explosions or accidents at nuclear stations or power plants.

Pathogenesis

Radiation sickness can be acute (subacute) or chronic, depending on the duration and magnitude of the learning impact, which determines the course of the changes that occur. The characteristic of the etiology of the appearance of pathology is that the acute form cannot become chronic or, conversely, unlike other diseases.

The appearance of certain signs of the disease directly depends on the dosage of the external radiation exposure received. In addition, the type of radiation is also important, because each of them has certain characteristics, including the power of the damaging effect on the body.

For example, α-rays have a high ionization density and a low penetrating property, due to which the sources of such radiation have a small spatial damaging effect.

ß-rays, with low penetration and low ionization density, affect tissues in areas of the body that are directly adjacent to the radiation source.

At the same time, γ-rays and X-rays lead to deep damage to tissues that have come under their influence.

Neutron beams affect organs unevenly, because their penetrating properties, as well as linear energy loss, can be different.

Symptoms of radiation sickness

Symptomatic manifestations of radiation sickness can be divided into several degrees of severity, which is explained by the dosage of the radiation received:

when exposed to 1-2 Gy, they speak of a slight lesion;
when exposed to 2-4 Gy - about the average degree;
when exposed to 4-6 Gy - about a severe lesion;
when exposed to radiation more than 6 Gy - about the defeat of an extremely severe degree.

Clinical signs in this case largely depend on the severity of the damage to the body.

Diagnosis of radiation sickness

When diagnosing a patient with irradiation of the body, it is first necessary to find out the dosage of rays to which the victim was exposed. Depending on this, further actions will be determined subsequently.

It is necessary to find out information from the patient or his relatives about the source of radiation, about the distance between him and the victim, about the duration of exposure, etc.
It is important to learn about the type of rays that have had an effect on a person.
The clinical picture, intensity and severity of symptoms are carefully studied.
Blood tests are carried out, preferably repeated within a few days.
Important information can be provided by a dosimeter - a special device that measures the amount of absorbed radiation.

Blood tests can provide the following information:

With light exposure (1-2 Gy):

lymphocytes - more than 20%;
leukocytes - more than 3000;
platelets - more than 80,000 in 1 µl.

With medium exposure (2-4 Gy):

lymphocytes - 6-20%;
leukocytes - 2000-3000;

For severe exposure (4-6 Gy):

lymphocytes - 2-5%;
leukocytes - 1000-2000;
platelets - less than 80,000 in 1 µl.

With extremely severe exposure (more than 6 Gy):

lymphocytes - 0.5-1.5%;
leukocytes - less than 1000;
platelets - less than 80,000 in 1 µl.

Additionally, such auxiliary research methods can be prescribed, which are not fundamental, but are of some value for clarifying the diagnosis.

Laboratory and diagnostic methods (microscopic examination of scrapings of ulcerative and mucous surfaces, analysis of blood sterility).
Instrumental diagnostics (electroencephalography, cardiography, ultrasound examination of the abdominal cavity, thyroid gland).
Consultation of doctors of narrow specializations (neuropathologist, hematologist, gastroenterologist, endocrinologist).

If necessary, differential diagnosis is carried out, although if there is reliable data on the fact of exposure, this moment is often missed.

The scheme for calculating the dose load using biological indicators in patients after exposure to ionizing radiation is called the term "biological dosimetry". In this case, it is not the total amount of radiated energy that was absorbed by the body that is calculated, but the ratio of biological disorders with the dose of a short single exposure. This technique helps to assess the severity of the pathology.

Radiation sickness treatment

In the acute form of radiation injury, the victim is placed in a special box, where appropriate aseptic conditions are maintained. Bed rest is prescribed.

First of all, such measures are taken as the treatment of wound surfaces, cleaning the stomach and intestines, eliminating vomiting, and normalizing blood pressure.

If the exposure is of internal origin, then certain drugs are administered, the action of which is aimed at neutralizing radioactive substances.

At first, a strong detoxification therapy is carried out, which includes intravenous administration of a saline or plasma-substituting solution, hemodez, and also forced diuresis. In case of damage to the gastrointestinal tract, dietary restrictions are prescribed in the first few days (a switch to parenteral nutrition is possible), treatment of the oral cavity with antiseptic liquids.

To eliminate hemorrhages, blood products, platelet or erythrocyte mass are administered. Possible transfusion of blood, plasma.

Antibacterial drugs are used to prevent infectious diseases.

In chronic radiation injury, symptomatic therapy is prescribed.

First aid for radiation sickness carried out in stages.

The victim must be subjected to pre-treatment: rid him of clothes, wash in the shower, be sure to rinse the mouth and nasal cavity, rinse his eyes. 2.
Next, gastric lavage should be carried out, if necessary, an antiemetic drug (for example, cerucal) should be given. 3.
After that, the doctor prescribes anti-shock and detoxification therapy, cardiac and sedative drugs.

In the first phase of the disease, drugs are prescribed that eliminate attacks of nausea and vomiting. With uncontrolled vomiting, 0.5 ml of a 0.1% solution of atropine is used s / c or / m. You can apply a drip of 50-100 ml of hypertonic sodium chloride solution. Severe radiation sickness may require detoxification treatment. Drugs such as norepinephrine, contrical, cordiamine, trasilol, or mezaton are prescribed to prevent the collaptoid state. The skin and accessible mucous membranes are treated with antiseptic solutions. An overly active intestinal microflora is inhibited by the intake of indigestible antibacterial drugs, such as gentamicin, neomycin, ristomycin, in combination with antifungal therapy.

With the development of infection, intravenous administration of large doses of antibiotics is used - tseporin, methicillin, kanamycin. Often such treatment is supplemented with biological preparations - antistaphylococcal, hyperimmune or antipseudomonal plasma. As a rule, antibacterial agents show their effect for 2 days. If a positive effect does not occur, then the drug is replaced by another, stronger one.

With an extremely severe lesion with suppression of immunity and a decrease in the function of hematopoiesis, a bone marrow transplant operation is performed. The transplanted material is taken from a donor, and the transplant itself is carried out after a course of immunosuppressants (to prevent rejection).

Alternative treatment

Folk methods used to eliminate the signs of radiation sickness include the use of garlic tincture, nettle leaves, chokeberry berries, eleutherococcus, sea buckthorn berries, ginseng, coconut, wild rose, grape and currant leaves, quince, seaweed, bee products, red wine. To improve the composition of the blood, plants such as knotweed, dandelion leaves, burdock, yarrow are used.

Mix 500 ml of red wine (preferably Cahors) with 500 ml of juice of the lower leaves of aloe, 500 g of flower honey and 200 g of ground calamus rhizome. Infuse the mixture for 2 weeks in the refrigerator, then use 1 tbsp. l. 1 hour before meals three times a day with milk.
600 ml of water and 3 tbsp. l. Boil dry oregano raw materials, insist overnight (you can in a thermos). In the morning, filter and drink 1/3-1/2 cup three times a day. It is allowed to add a spoonful of honey. The duration of treatment depends on the condition of the patient and may continue until persistent signs of improvement.
1 st. l. mix chagi with 200 ml of boiling water, leave for 15 minutes, then add baking soda at the tip of a knife and leave for 10 minutes. Take the medicine three times a day for 1 tbsp. l. half an hour before meals.
Pour 1 cup of flax seeds with two liters of boiling water and cook for about 2 hours. Remove from fire and cool. Take 100 ml up to 7 times a day.
2 tbsp. l. boil lingonberry berries for 10 minutes in 500 ml of water, then leave for 1 hour under the lid. Take 250 ml twice a day after meals.

Herbal treatment cannot be independent. Such treatment should only be combined with traditional medical therapy prescribed by a medical specialist.

Homeopathy for radiation sickness

The effectiveness of homeopathic medicines in the treatment of radiation sickness has not yet been thoroughly proven. However, American scientists continue to experiment, looking for ways to protect humans from harmful radiation.

One drug that has successfully withstood all research and testing is the food supplement Fucus vesiculosus. This remedy blocks the absorption of radioactive rays by the thyroid gland, preventing its receptors from carrying out their function. This dietary supplement is made from seaweed.

A remedy such as Cadmium sulphuratum also has a similar effect. Among other things, this drug significantly alleviates the signs of radiation sickness, such as itchy skin, dyspeptic disorders, and muscle pain.

However, it should be noted that there is no direct evidence of the effectiveness of these drugs yet, so the decision to use them is quite risky. Before you start taking homeopathic remedies, consult your doctor.

Prevention and prognosis of radiation sickness

The calculation of the prognosis of radiation sickness directly depends on the amount of radiation exposure received and the duration of its exposure. Victims who survived the critical period (which is 3 months) after radiation injury have every chance of a favorable outcome. But even in the absence of mortality, patients may have some health problems in the future. Blood diseases, malignant tumors in almost any organs and tissues can develop, and the next generation has a high risk of developing genetic disorders.

Preventive measures against radiation injury may include the installation of protective elements on the torso or individual parts of the body (the so-called screens). Employees of dangerous enterprises undergo certain training, put on special clothes. Also, people at risk may be prescribed drugs that reduce the sensitivity of tissues to radioactive rays. It is mandatory to take vitamins of group B, as well as C and P.

People who have regular contact with sources of radiation should periodically attend preventive examinations and take a blood test.

Radiation sickness is a difficult disease that cannot be cured on its own. And it’s hardly worth the risk, because the consequences of such a pathology are very serious. Therefore, in case of any suspicion of exposure, even if there are no symptoms of damage, it is necessary to consult a doctor and undergo the necessary examinations.

It's important to know!

Radiation sickness or radiation damage to a number of organs, including the intestines, develops with the use of nuclear weapons (the tragedy in Hiroshima and Nagasaki in 1945), violation of safety regulations and negligence with sources of ionizing radiation (the events at the Chernobyl nuclear power plant), irrational administration of large doses of radiation therapy.

20.10.2017

Ionizing radiation causes a number of changes in the body, doctors call such a complex of symptoms radiation sickness. All signs of radiation sickness are distinguished depending on the type of radiation, its dosage and the location of the harmful source. Due to harmful radiation, processes begin to occur in the body that threaten to malfunction in the functioning of systems and organs.

Pathology is included in the list of diseases, because of it, irreversible processes develop. The current level of medicine allows you to slow down the destructive processes in the body, but not to cure a person. The severity of the course of this disease depends on how much area of the body was irradiated, how long and how exactly the human immune system reacted.

Doctors distinguish between forms of pathology when irradiation was general and local, and also distinguish combined and transitional varieties of pathology. Due to penetrating radiation, oxidative processes begin in the cells of the body, as a result they die. The metabolism is seriously disturbed.

The main impact of exposure falls on the gastrointestinal tract, the nervous and circulatory system, and the spinal cord. In case of violation in the work of systems, dysfunctions arise in the form of combined and single complications. A complex complication occurs with a lesion of the 3rd degree. Such cases end fatally.

Pathology proceeds in a chronic form, what is radiation sickness in a specific form, the doctor can determine the magnitude and duration of exposure. Each of the forms has a development mechanism, therefore, the transition of the identified form to another is excluded.

Types of harmful radiation

In the development of pathology, an important role is assigned to a specific type of radiation, each has a particular effect on different organs.

The main ones are listed:

alpha radiation. It is characterized by high ionization, but low ability to go deep into tissues. Sources of such radiation are limited in their damaging effect;
beta radiation. It is characterized by weak ionizing and penetrating power. Usually affects only those parts of the body, which are closely adjacent to the source of harmful radiation;
gamma and x-ray radiation. Such types of radiation are capable of hitting tissues to a serious depth in the source area;
neutron radiation. It differs in different penetrating ability, which is why organs with such irradiation are affected heterogeneously.

If the exposure reaches 50-100 Gy, then the main manifestation of the disease will be CNS damage. With such symptoms, you can live 4-8 days.

When irradiated with 10-50 Gy, the organs of the gastrointestinal tract are more damaged, the intestinal mucosa is rejected and death occurs within 2 weeks.

With a slight exposure (1-10 Gy), the symptoms of radiation sickness are manifested by bleeding and hematological syndromes, as well as complications of an infectious type.

What causes radiation sickness?

Irradiation is external and internal, depending on how the radiation enters the body - percutaneously, with air, through the gastrointestinal tract, mucous membranes or in the form of injections. Small doses of radiation always affect a person, but pathology does not develop.
One speaks of a disease when the radiation dose is 1-10 Gy or more. Among those who risk learning about a pathology called radiation sickness, what it is and why it is dangerous, there are groups of people:

receiving low doses of radioactive exposure in medical facilities (X-ray employees and patients who must undergo examinations);
who received a single dose of radiation during experiments, during man-made disasters, from the use of nuclear weapons, during the treatment of hematological diseases.

Signs of radiation exposure

When radiation sickness is suspected, symptoms appear depending on the dose of radiation and the severity of complications. Doctors distinguish 4 phases, each with its own symptoms:

- The first phase occurs in people who have received radiation at a dosage of 2 Gy. The rate of onset of clinical signs is dose dependent and measured in hours and minutes. The main symptoms are nausea and vomiting, dryness and bitterness in the mouth, fatigue and weakness, drowsiness and headaches. A shock condition is detected, in which the victim faints, an increase in temperature, a drop in pressure, and diarrhea can be detected. Such a clinical picture is typical for irradiation at a dosage of 10 Gy. In victims, the skin turns red in those areas that have been in contact with radiation. There will be a change in pulse, low pressure, trembling fingers. On the first day from the moment of irradiation, the number of lymphocytes in the blood decreases - the cells die.

The second phase is called sluggish. It begins after the first phase has passed - approximately 3 days after exposure. The second stage lasts up to 30 days, during which the state of health returns to normal. If the irradiation dosage is more than 10 Gy, then the second phase may be absent, and the pathology passes into the third. The second phase is characterized by skin lesions. This indicates an unfavorable course of the disease. A neurological clinic appears - eye proteins tremble, motor activity is disturbed, reflexes are reduced. By the end of the course of the second stage, the vascular wall becomes weak, blood clotting slows down.
The third stage is characterized by the clinical picture of the disease. The timing of its onset depends on the dose of radiation. Phase 3 lasts 1-3 weeks. Become noticeable: damage to the circulatory system, decreased immunity, autointoxication. The phase begins with a serious deterioration in well-being, fever, increased heart rate and a drop in blood pressure. The gums bleed, the tissues swell. The mucous organs of the gastrointestinal tract and mouth are affected, ulcerations appear. If the radiation dose is low, the mucosa is restored over time. If the dose is high, the small intestine is damaged, which is characterized by bloating and diarrhea, abdominal pain. There are infectious tonsillitis and pneumonia, the hematopoietic system is inhibited. The patient has hemorrhages on the skin, digestive organs, mucous membrane of the respiratory system, ureters. Bleeding is strong enough. The neurological picture is manifested by weakness, confusion, meningeal manifestations.
In the fourth stage, the structures and functions of the organs improve, bleeding disappears, hair loss begins to grow, and damaged skin heals. The body recovers for a long time, more than 6 months. If the radiation dose was high, rehabilitation may take up to 2 years. If the last, fourth, phase is over, we can say that the person has recovered. Residual effects can be manifested by pressure surges and complications in the form of neuroses, cataracts, leukemia.

Radiation sickness options

The classification of the disease by type is carried out according to the duration of exposure to radiation and dose. If the body is exposed to radiation, they speak of an acute form of pathology. If the irradiation is repeated in small doses, they speak of a chronic form.
Depending on the dosage of the radiation received, the following forms of damage are distinguished:

- less than 1 Gy - radiation injury with reversible damage;
- from 1-2 to 6-10 Gy - a typical form, another name is bone marrow. Develops after short exposure. Mortality occurs in 50% of cases. Depending on the dosage, they are divided into 4 degrees - from mild to extremely severe;
- 10-20 Gy - gastrointestinal form arising from short-term exposure. Accompanied by fever, enteritis, septic and infectious complications;

20-80 Gy - toxemic or vascular form arising from single-stage irradiation. Accompanied by hemodynamic disturbances and severe intoxication;
over 80 Gy - cerebral form, when death occurs within 1-3 days. The cause of death is cerebral edema.

The chronic course of the pathology is characterized by 3 periods of development - in the first a lesion is formed, in the second - the body is restored, in the third there are complications, consequences. The first period lasts from 1 to 3 years, during which the clinical picture develops with varying severity of manifestations.

The second period begins when radiation ceases to act on the body or the dosage is reduced. The third period is characterized by recovery, then partial recovery, and then stabilization of positive changes or progression.

Radiation sickness treatment

Irradiation with a dosage of more than 2.5 Gy is fraught with a fatal outcome. From a dose of 4 Gy, the condition is considered fatal. Timely and competent treatment of radiation sickness from exposure to a dose of 5-10 Gy still gives a chance for clinical recovery, but usually a person dies from a dose of 6 Gy.

When radiation sickness is established, treatment in the hospital is reduced to an aseptic regimen in the wards designated for this. Symptomatic therapy and prevention of infections are also indicated. If fever and agranulocytosis are detected, antibacterial and antiviral drugs are prescribed.

The following are used in treatment:

Atropine, Aeron - stop nausea and vomiting;
physiological saline - against dehydration;
Mezaton - for detoxification on the first day after exposure;
gamma globulin increases the effectiveness of anti-infective therapy;
antiseptics for the treatment of mucous membranes and skin;
Kanamycin, Gentamicin and antibacterial drugs inhibit the activity of the intestinal flora;
donor platelet mass, irradiated with a dose of 15 Gy, is injected to replace the deficiency in the victim. If necessary, appoint a transfusion of erythrocytes;
hemostatics of local and general effects to combat bleeding;
Rutin and vitamin C, hormones and other drugs that strengthen the walls of blood vessels;
Fibrinogen to increase blood clotting.

In the room where patients with radiation sickness are being treated, infections are prevented (both internal and external), sterile air is supplied, the same applies to food and materials.

With local damage to the mucous membranes, they are treated with bactericidal mucolytics. Lesions on the skin are treated with collagen films and special aerosols, dressings with tannins and antiseptic solutions. Bandages with hydrocortisone ointment are shown. If ulcers and wounds do not heal, they are excised and plastic surgery is prescribed.

If the patient develops necrotic enteropathy, antibacterial drugs and Biseptol are prescribed to sterilize the gastrointestinal tract. At this time, the patient is shown fasting. You can drink water and take medicine for diarrhea. In severe cases, parenteral nutrition is prescribed.

If the radiation dosage was high, the victim has no contraindications, a suitable donor has been found, and bone marrow transplantation is indicated. The motive for the procedure is a violation of the process of hematopoiesis, suppression of the immunological reaction.

Complications of radiation sickness

It is possible to predict the state of health of a patient taking into account the degree of exposure and the duration of the harmful effects on the body. Those patients who survived after 12 weeks from the moment of irradiation have a lot of chances. This period is considered critical.

Even from radiation, which is not fatal, complications of varying severity develop. It will be a malignant neoplasm, hemoblastosis, the inability to have children. Distant disorders can occur in offspring at the genetic level.

The patient has an exacerbated chronic infection. The vitreous body and the lens become cloudy, vision is impaired. In the body, dystrophic processes are detected. Contacting the clinic will give the maximum chance to prevent the development of consequences.

Radiation sickness is considered a severe and dangerous pathology, which is manifested by a complex of various symptoms. While doctors have not developed a treatment, treatment is aimed at maintaining the body and reducing negative manifestations.

Of paramount importance in the prevention of such disease is the exercise of caution in the vicinity of potential sources of hazardous radiation.

If a person is exposed to ionizing radiation, he develops radiation sickness. For signs of this disease to appear, the level of radiation exposure is from 1 to 10 Gy or higher. But changes in the human body are also observed at low radiation doses of 0.1-1 Gy.

Exposure to ionizing radiation is detrimental to humans

There are many sources of radiation. Small doses of radiation enter the human body through breathing, food, and water. If you live in an area with a good radiation background, then a person receives a safe dose of 1–3 mSv per year. If it is more than 1.5 Sv per year, or if the victim immediately received a dose equal to 0.5 Sv, he develops radiation sickness.

Causes

You can get sick with radiation sickness (R.S.) due to a single or short-term exposure to strong radiation or from regular exposure to small doses of radiation. In the first case, the causes of occurrence are nuclear disasters or nuclear weapons, the treatment of oncological diseases, etc.

In the second case, hospital staff who are forced to work in departments with X-ray machines or patients who often undergo X-ray examinations fall ill, that is, the causes of the appearance are related to the fact that a person is forced to deal with radiation.

Neurons, particles, etc. get inside the body and damage internal organs. Changes occur at the cellular and molecular level. First of all, damage to the bone marrow, as well as endocrine glands, intestines, skin, etc. With the development of L.b. a person does not feel pain, he has no other sensations.

Types of radiation sickness

Acute radiation sickness occurs with a single strong exposure to radiation

Classification L.b. depends on the dose of radiation and the time when the person was under its influence. There are two types of LB: acute radiation sickness and chronic radiation sickness. The first appears with a single strong exposure to radiation. The second - when the effect was long, but the doses were small. Acute form L.b. It is subdivided into several types, which depend on the strength of radiation.

L.b. there are three periods. The first is the formation, which lasts 1-3 years, when the clinical syndrome develops. Then comes the recovery period, which begins only 1-3 years after the end of radiation exposure. The third period is the consequences. A person can fully recover, or he will have an incomplete recovery, and the changes either progress or stabilize.

Symptoms of the disease

What symptoms indicate that a person has L.b.? There are many of them, and they depend on whether the disease is acute or chronic.

Symptoms of acute L.b.

Acute radiation sickness occurs after short-term exposure to significant doses of radiation. A typical case of this disease is its bone marrow form. It is divided into four phases.

I - appears in the first minutes after exposure to radiation

In the first minutes after exposure to radiation: nausea, vomiting, weakness

The patient's symptoms are as follows:

nausea and vomiting;
weakness, sleepy all the time;
headache;
in the mouth a feeling of bitterness, dryness;
if the dose is higher than 10 Gy: a person has a fever, he has diarrhea, arterial hypotension, he loses consciousness.

II - phase of well-being, imaginary, a person gets better

This is an improvement on day 3-4, this condition lasts 2 to 4 weeks. The patient is all right, but there are still changes in the body: reflexes decrease, coordination is disturbed, the EEG indicates the appearance of slow rhythms. All these symptoms show that the disease is progressing. On the 12-17th day the person becomes bald. If a large dose of radiation was received (over 10 Gy), then the second phase may not be, the symptoms of the third immediately appear.

III - phase when the symptoms of the disease make themselves felt

The victim's condition is rapidly deteriorating. He has the following symptoms:

weakness;
fever;
gums bleed;
nosebleeds and hemorrhages appear, etc.;
there is stomatitis, pharyngitis, gastroenteritis, etc.;
develops pneumonia, tonsillitis, etc.;
hair falls out on the head, pubis and chest, a person loses eyelashes and eyebrows;
show signs of damage to the gastrointestinal tract. Patients feel sick, vomit, abdominal pain, diarrhea, blood is visible in the feces.

Exposure to high doses affects human skin

Signs of a neurological syndrome: adynamia, confusion, decreased muscle tone, etc. Features of this disease - if there was exposure to high doses, this is reflected in the human skin. Radiation dermatitis appears. On the skin of the elbows, neck, armpits, in the groin area, erythema is visible. Later, there is swelling of the skin and blistering. If the disease has a favorable course, everything ends with the appearance of scars and pigmentation.

And in other cases, ulcers may appear. Skin lesions also go through several stages of development: first, primary erythema, then edema appears, secondary erythema and the appearance of ulcers and blisters on the skin. Sometimes the vessels of the skin change so much that healed wounds after some time, sometimes a long one, cause repeated necrosis, and doctors are forced to amputate the limb. Therefore, the condition of the skin must be monitored and properly treated

The thyroid gland, adrenal glands, etc., suffer greatly. The features of this disease are the occurrence of thyroid cancer later. These and other symptoms are characteristic of the third phase of the disease.

IV - recovery phase

A person is much better, many signs of the disease disappear, but for a long time he suffers from anemia and asthenovegetative syndrome. Acute radiation sickness is dangerous because it has serious consequences. The consequences of radiation sickness are as follows: cataracts develop, a person cannot have children, he has cirrhosis of the liver, neuroses appear, malignant tumors develop, etc.

Acute radiation sickness is dangerous because it has serious consequences

Symptoms of chronic L.b.

If someone regularly receives relatively small doses of radiation, he develops chronic radiation sickness. There are several degrees of chronic L.b. Consider its features, symptoms.

Easy degree. All changes in the human body are reversible. The symptoms of the disease are as follows:

weakness;
performance at a low level;
headache;
insomnia;
unstable emotional background;
decreased appetite;
gastritis and other diseases;
in women, the menstrual cycle is disturbed, libido decreases;
in men - impotence.

Features of easy degree L. b. that a person can make a full recovery.

Average degree. Symptoms:

the victim is often dizzy;
he is very emotional and excitable;
fails memory;
sometimes loses consciousness;
nails are deformed, dermatitis appears;
arterial hypotension is observed;
nosebleeds, bleeding gums;
bone marrow disease, etc.

Chronic radiation sickness is also dangerous

Severe degree. Signs:

headache;
no sleep;
bleeding, and hemorrhages are possible;
teeth fall out;
baldness;
severe changes in the bone marrow.

Often the signs of the disease are aggravated, the person's condition is getting worse every day, he can die. Chronic radiation sickness is also dangerous, and timely treatment will save a person's life.

How to behave during an accident

A person cannot influence the development of acute radiation sickness, but you need to know how to act at the time of the accident.

Accident at reactor plants

Leave the premises. Regardless of the state of health, everyone must leave the scene of the accident, those who are not able must be endured. If there is a first-aid post nearby, take it there, if it is not there, then a trip by car is undesirable, it can provoke vomiting.
Heavily injured people should be placed separately from each other. This is necessary so that the type of vomiting of one does not provoke another.
Transfer to clinic. As soon as the vomiting stops, the victims must be taken to the clinic.

Correct actions at the time of an accident are practiced in exercises

Accident, release of radioactive gases

Immediately leave the scene of the accident Emergency care is to get out of the gas cloud as quickly as possible. Sometimes every second counts. If you're lucky, you can avoid strong exposure and brain damage. Often people who are in one place nearby had a different degree of damage, because. there was a slight time difference.
You can not pick up anything or sit down.
Respirators must be put on immediately.
Drink a tablet of potassium iodide or 3 drops of iodine tincture, diluting it in water.
After leaving the room, you need to wash yourself in the shower using soap. Clothes are also taken off, you can’t put them on.
Everyone should take adsobar.

Treatment

The help of a doctor is needed in the diagnosis. Diagnostic method - blood test and other studies.

Emergency care is that the patient is washed out the stomach and put an enema. Needs skin treatment. Then they give antiemetics. The patient is placed in a sterile box and prescribed bed rest. On the first day, detoxification therapy, forced diuresis are carried out. If bacterial complications appear, it is necessary to immediately prescribe treatment and drink drugs. Most often, antibiotics are used, which are administered 2-3 times a day.

Treatment of radiation sickness depends on the severity of the disease.

If necrotic enteropathy appears, emergency care is fasting until it is eliminated (about 11.5 weeks), only water is allowed to drink. Appoint care for the oral mucosa. If the disease is in a chronic form, physiotherapy is prescribed. The doctor also prescribes drugs that tone and strengthen the body, treat with B vitamins.

Treatment L.b. also depends on the severity of the disease. If the patient has a 1st or 2nd degree, he is prescribed antihistamines, this is his necessary help. Be sure to give vitamins, antibiotics. At stage 3, the patient should drink antihemorrhagic drugs. A blood transfusion is also required. At 4 degrees, hematopoietic stimulants are used.

After the signs and symptoms of radiation sickness disappear (skin lesions, intestinal manifestations, bone marrow problems), the person recovers, but asthenia persists. The patient still needs the help of a doctor. Such treatment of radiation sickness is successful. A chronic disease is not so dangerous, but there is no complete recovery from it. The consequences of this disease are tumors, so the help of a doctor, including in regular examinations, in order to detect and cure cancer in time.

Prevention

Prevention of radiation sickness, the method of its prevention, is the observance of all norms when working with radioactive substances. There is no way to protect against this disease. The only effective way is shielding. There are drugs that make the body less sensitive to radiation. They take vitamins B6, P, C, and some hormonal and anabolic drugs. They also came up with drugs for the prevention of L.b. , but they have almost no effect, besides, they have too many side effects.