體內放射核種污染的處理

放射性汙染種類

體外放射汙染
體內吸入放射汙染
體內食入放射汙染
傷口汙染 (例如放射性髒彈 radioactive shrapnel)

常見的放射核種汙染

Strontium(Sr)-90, Yttrium(Y)-90, Cesium(Cs-137), Iridium(Ir)-192, Cobalt(Co)-60, Americium(Am)-241, Iodine (I)-125/131, Uranium(U)-234, 235, 238, Plutonium(Pu)-239, Radium(Ra)-239, Tritium (H)-3, Phosphorus (P)-32, Palladium(Pd)-103, 以及上述的混和物!

處理放射何種汙染步驟

辨識放射核種種類
篩檢傷患
體內放射汙染定量測定
界定治療閥值: 可以考量該放射物質在工作人員的允許攝入值 allowable level of intake (ALI's)，或是基於除汙效益採用較高的閥值，或是政策性的採用較低閥值)
儲存藥物包括: Prussian blue, Ca/Zn-DTPA, Ca Gluconate, Na alginate, D-penicillamine, Ammonium chloride, Na bicarbonate, Dimercaprol(BAL)

除汙策略

清除肺部吸入物: 利用纖毛作用 (Ciliary action) 將吸入物移至嘴巴或是腸胃道，針對嚴重病患可以進行利用肺部灌洗 (pulmonary lavage)
清除腸胃道食入汙染: 加速腸胃蠕動 (例如使用輕瀉藥) 加速放射核種排出體外; 利用化學特性結合放射核種 (例如使用Prussian blue); 或是食用穩定性核種來競爭吸收。
清除血液汙染: 抑制體內器官吸收放射核種(例如使用碘化鉀阻礙放射碘被甲狀腺吸收)，改變放射核種的化學狀態 (例如加入 Na Bicarbonate來改變 uranium 毒性)，利尿劑加速清除 (治療氚H-3中毒)，服用螯合物協助清除 ( 例如 Ca/Zn-DTPA)

建議治療方式

參考資料

Most of the material contained herein comes from NCRP Report No. 65, Management of Persons Accidentally Contaminated with Radionuclides, April 15, 1980. This publication may be ordered on line at www.ncrp.com for $50.00.
In response to requests for information related to the radiological aspects of the Fukushima Nuclear Reactor Accident, NCRP has made Commentary No. 10, Advising the Public About Radiation Emergencies available for free download

Commentary No. 10, Advising the Public About Radiation Emergencies — In response to requests for information related to the radiological aspects of the Fukushima Nuclear Reactor Accident, NCRP has made Commentary No. 10, Advising the Public About Radiation Emergencies available for free download

SNM annual meeting Philadelphia 2004 — Administration of decorporation drugs to treat internal radionuclide contamination, by Carol S. Marcus, Ph.D., M.D.

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