Nutrition treatment scheme for a patient exposed to Nanjing '5.7' ¹⁹²Ir source accident

Objective: To provide nutritional supportive scheme for patients with radiation injury through the treatment of the one exposed to Nanjing ¹⁹²Ir source accident. Methods: The reasonable nutrition treatment scheme was made on the basis of dietary survey and nutritional index monitoring during clinical stages of the patient, including body weight, body mass index(BMI), biochemical indexes, electrolyte, etc., as well as metabolic cart determination of resting energy expenditure (REE). Results: Patient on admission (days 5 post-irradiated) weighing 42.5 kg, 172 days after the first irradiated (the first skin grafting) fell to a minimum of 36 kg, then gradually rise, hen rose back to normal range on days 383 before discharge. Normal admission hemoglobin was 135 g/L, 172 d after irradiated to a minimum of 54 g/L, normal discharge; when lymphocytes admission low as 0.5 × 10⁹/L, 58 days back to normal after exposure, 172 days after irradiated down to 0.4 × 10⁹/L. Serum albumin was normal admission 41.2 g/L, 172 days after irradiated down to 25.3 g/L. The normal level of serum prealbumin was 0.22 g/L, 248 days to a minimum of 0.04 g/L, the basic return to normal at discharge was 0.17 g/L. Admission normal liver function, bilirubin index slightly higher, the 'all in one' parenteral nutrition after about 2.5 months later, bilirubin and liver function indicators were gradually increased, the adjusted treatment and nutrition liver and gallbladder and other gradually returned to normal after treatment. REE and the body weight were determined by metabolic cart on days 294, 308 and 342 for the energy requirements. Conclusions: For patient with radiation injury, appropriate nutrition therapy is a key method for the clinical treatment and rehabilitation, which can maintain the nutritional status of patients and improve clinical treatment. (authors)