Выраженная трансформация показателей инвалидизации лиц, которые причастны к последствиям аварии на ЧАЭС, с уменьшением численности пациентов-ликвидаторов в отличие от других категорий пострадавших обусловлена старением населения на протяжении двух десятилетий и смертностью инвалидов из числа участников послеаварийных работ.
Аргументировано, что «чернобыльский» опыт можно использовать для верификации медико-биологических последствий других техногенных инцидентов, когда речь идет о малых дозах низкой интенсивности, результирующие эффекты которых наглядно проявляются в камбиальных элементах различных тканей отдельных иммунокомпетентных клетках и в системе соединительной ткани.
Утверждается, что на всех этапах медицинского обеспечения ликвидации крупномасштабной радиационной аварии существенное внимание должно уделяться применению ентеросорбентов. Их использование также целесообразно в ветеринарии – для опосредованной защиты человеческой популяции от влияния агрессивных полютантов окружающей среды.
Ключевые слова: медико-социальное обеспечение, крупномасштабная радиационная авария, Чернобыльская катастрофа, радиобиологические эффекты, патоморфоз.
SUMMARY
Pishchykov V.A. Scientifical-methodical ground of organizing of medical-social providing of large-scale radiation failure liquidation (on example of the Chernobyl accident) . — Manuscript.
Dissertation on the receipt of scientific degree of doctor of medical sciences on specialities 03.00.01 — radiobiology and 14.02.03 — social medicine — The Scientific Centre for Radiation Medicine of AMS of Ukraine. Kyiv, 2008.
The dissertation is devoted to ground of organization principles of medical-social providing of affected by large-scale radiation accident people (standards of examination, treating and prophylaxis) and legal accompaniment on the different stages of accident negative sequels liquidation. The ground is coming from the results of complex researches (including pathomorphological one) of remote radiobiological, medical-social and expert problems concerned the Chernobylaccident.
Original sources (normative legal acts, methodical works and scientific publications) were studied in relation to medical-social providing organizing on all of the stages of the ChNPP accident negative sequels minimizing. They were analyzed from radiobiology positions and they were systematized in a handy kind.
Clinical-dosimetric evaluation of involved to the researches affected people groups was carried out.
It was proved that the most important radiobiological sequel of large-scale radiation accident concerning affected people is the induced pathomorphism of diseases. Its essence and clinical-morphological accordance and prognostic aspects were clarified with regards to the most widespread diseases among these population cohorts.
Methodical principles of recognition of pathology caused by the Chernobylaccident factors were analyzed in view of expert commissions work problems. The own version of principles of delimitation of induced by the failure components pathological processes was presented.
Efficiency of cardinal regulations of Chernobyl legislation during after accident period was investigated and actual to date medical-social measures associated with the Chernobylfailure consequences liquidation were based.
The conception of medical-social providing on stages of large-scale failure liquidation was formulated proceeding from «Chernobyl experience».
Key words: medical-social providing, large-scale radiation failure, Chernobylaccident, radiobiology effects, pathomorphism.
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