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Causes of death were analysed for two groups of subjects exposed to radiation in 1986 because of the Chernobyl accident. 27 victims were exposed to external gamma-radiation (4.3-13.7 Gy) in the moment of or few hours after the accident. Most of these subjects had radiation sickness of different severity in combination with local radiation lesions. 2 victims had severe thermal burns. 405 victims worked as wreckers or emergency teams members in the contaminated area in different time after the accident. They died most frequently of traumas, accidents, cancer, cardiovascular diseases. Most of deaths in this group were attributed to general somatic causes unrelated to the hazards of the ionizing radiation.

The paper is concerned with the results of therapy of 115 patients with acute radiation syndrome after the Chernobyl accident. The chief methods of the effective therapy of bone marrow syndrome are antimicrobial drugs and fresh donor platelet mass transfusions. Hemopoietic stem cell transplantation (allogenic bone marrow or embryonic hepatocytes) is indicated and effective in a very limited number of patients in accident irradiation. Severe beta-burns of the skin remain an unsolved problem as a result of their spreading. Organizational principles of therapy of a great number of patients with acute radiation syndrome in a specialized hospital were described.

One hundred and fifteen patients with acute radiation disease of degrees I to IV affected during the accident at the Chernobyl APS were treated in a specialized hospital. The anti-infection regimen included isolation, air sterilization with ultraviolet light, intravenous administration of broad spectrum of antibiotics (gentamicin, cephalosporins and carbenicillin) and nystatin. Some cases were treated with amphotericin. Some cases were treated with amphotericin B. Out of 22 patients who died at the early periods (days 14 to 34) or at the period of agranulocytosis in 7 patients sepsis was stated. In 5 of them it was complicated by pneumonia. In 5 patients who died at the late periods (days 48 to 99) or at the period of hemopoiesis normalization infectious complications by the death moment were stated: sepsis in 3 patients and pneumonia in 2 patients. The aspect of the microbiological diagnosis and therapy efficacy is discussed.