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中国老年医学学会烧创伤分会, 中华医学会组织修复与再生分会, 中国康复医学会再生医学与康复专业委员会, 等. 放射性皮肤损伤的诊断和治疗专家共识(2024版)[J]. 中华烧伤与创面修复杂志, 2024, 40(8): 701-712. DOI: 10.3760/cma.j.cn501225-20240126-00033.
引用本文: 中国老年医学学会烧创伤分会, 中华医学会组织修复与再生分会, 中国康复医学会再生医学与康复专业委员会, 等. 放射性皮肤损伤的诊断和治疗专家共识(2024版)[J]. 中华烧伤与创面修复杂志, 2024, 40(8): 701-712. DOI: 10.3760/cma.j.cn501225-20240126-00033.
Burn and Trauma Branch of Chinese Geriatric Society,Tissue Repair and Regeneration Branch of Chinese Medical Association,Regenerative Medicine and Rehabilitation Professional Committee of Chinese Rehabilitation Medical Association,et al.Expert consensus on diagnosis and treatment of radiation-induced skin injury (2024 version)[J].Chin J Burns Wounds,2024,40(8):701-712.DOI: 10.3760/cma.j.cn501225-20240126-00033.
Citation: Burn and Trauma Branch of Chinese Geriatric Society,Tissue Repair and Regeneration Branch of Chinese Medical Association,Regenerative Medicine and Rehabilitation Professional Committee of Chinese Rehabilitation Medical Association,et al.Expert consensus on diagnosis and treatment of radiation-induced skin injury (2024 version)[J].Chin J Burns Wounds,2024,40(8):701-712.DOI: 10.3760/cma.j.cn501225-20240126-00033.

放射性皮肤损伤的诊断和治疗专家共识(2024版)

doi: 10.3760/cma.j.cn501225-20240126-00033
基金项目: 

国家自然科学基金重点项目 82030056

详细信息

    通信作者:史春梦,陆军军医大学(第三军医大学)火箭军医学教研室,创伤与化学中毒全国重点实验室,重庆 400038,Email:shicm@tmmu.edu.cn周晓,湖南省肿瘤医院肿瘤整形外科,长沙 410013,Email:zhouxiao@hnca.org.cn郭光华,南昌大学第一附属医院烧伤整形与创面修复医学中心,南昌 330006,Email:guogh2000@hotmail.com

Expert consensus on diagnosis and treatment of radiation-induced skin injury (2024 version)

Funds: 

Key Program of National Natural Science Foundation of China 82030056

  • 摘要: 放射性皮肤损伤是皮肤组织受到大剂量电离辐射作用后引起的损伤,是肿瘤局部放射治疗最常见的并发症,在核事故、放射事故和长期职业暴露等条件下也可发生。目前,国内外对于放射性皮肤损伤的诊断尚未统一标准,对其预防和治疗缺乏有效手段,亟待更多循证医学研究探索。结合国内外文献、国家职业卫生标准和现有临床经验,该共识编写组组织国内外相关领域专家,反复研讨制订针对当前放射性皮肤损伤诊断和治疗的专家共识,供临床使用参考。

     

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  • 图  1  放射性皮肤损伤的诊断和治疗推荐意见

    注:EGCG为表没食子儿茶素-3-没食子酸酯,EGF为表皮生长因子,GM-CSF为粒细胞-巨噬细胞集落刺激因子《放射性皮肤损伤的诊断和治疗专家共识(2024版)》编写组

    Table  1.   牛津大学循证医学中心证据分级标准

    证据级别具体描述
    Ⅰa基于多个RCT的系统评价,且文献的同质性好
    Ⅰb单个RCT研究,且可信区间窄
    Ⅰc全或无的病例系列研究
    Ⅱa基于多个队列研究的系统评价
    Ⅱb单个队列研究或质量较差的RCT
    Ⅱc结局研究或病因学研究
    Ⅲa病例对照研究的系统评价
    Ⅲb病例对照研究
    单个病例系列研究
    专家意见
    注:RCT为随机对照试验
    下载: 导出CSV

    Table  2.   急性放射性皮肤损伤分度诊断标准

    分度初期反应期假愈期症状明显期参考剂量(Gy)
    毛囊丘疹、暂时脱毛≥3
    红斑2~6周脱毛、红斑≥5
    红斑、烧灼感1~3周二次红斑、水泡≥10
    红斑、麻木、瘙痒、水肿、刺痛数小时~10 d二次红斑、水泡、坏死、溃疡≥20
    注:该表引自《职业性放射性皮肤疾病诊断》(GBZ 106-2020)[1];“—”表示无此项
    下载: 导出CSV

    Table  3.   慢性放射性皮肤损伤分度诊断标准

    分度临床表现参考剂量(Gy)
    急性迁延慢性累积
    皮肤色素沉着或脱失、粗糙,指甲灰暗或纵嵴色条甲≥5≥15
    皮肤角化过度,皲裂或萎缩变薄,毛细血管扩张,指甲增厚变形≥10≥30
    坏死溃疡,角质突起,指端角化融合,肌腱挛缩,关节变形,功能障碍(具有其中1项即可)≥20≥45
    注:该表引自《职业性放射性皮肤疾病诊断》(GBZ 106-2020)[1]
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  • 收稿日期:  2024-01-26

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