肺部病变介入放射治疗中患者的X射线辐射评价  

Evaluation of radiation exposure in patients with pulmonary diseases receiving interventional radiology therapy procedures

作　　者：陈胜利[1] 黄齐好[1] 朱栋梁[1] 黄子诚[1] 陈国东[1] 慕容爱[1] 邹蓉珠[1] 

机构地区：[1]广州市第一人民医院,广东广州510180

出　　处：《中国职业医学》2004年第4期31-33,共3页China Occupational Medicine

摘　　要：目的　研究肺癌灌注化疗与咯血栓塞介入放射治疗过程中患者所经受的X射线辐射。方法　回顾性分析 43例肺癌与 3 5例咯血患者的辐射资料。采用Siemens公司DSA机Angiostar Plus随机配置剂量监测系统 (DiamentorK1andDiamentor) ,在线测量剂量面积乘积 (DAP ,cGycm2 )和入射表面剂量 (ESD ,mGy) ;采用Monte Carlo转换因子估算有效剂量(ED ,mSv)。结果　 3项剂量的范围和中位数分别为 :①DAP为 12 5 0～ 47991cGycm2 和 73 3 4cGycm2 ,②ESD为 62～ 13 41mGy和 43 7mGy ,③ED为 1 75～ 67 19mSv和 10 2 7mSv。透视对DAP与ED的贡献为总剂量的 ( 2 6 7± 14 4) % ,摄影剂量占总剂量的 ( 73 3± 14 4) %。肺癌动脉灌注化疗组的摄影剂量值大于咯血动脉栓塞组。结论　患者在接受胸部介入治疗时一次接受了大剂量的X射线辐射 ,减少摄影总帧数是减少患者辐射剂量最有效的方法。Objective To study X-ray radiation exposure in patients with pulmonary diseases during interventional radiology(IVR) therapy procedures (lung cancer infusion chemo-therapy and emptysis embolisation therapy) by DSA model. Methods 78 lung disease cases(43 cases of lung cancer and 35 patients with emptysis) receiving IVR therapy were included in the present study, Angiostar-Plus(Siemens) equipped dose measure system (Diamentor K1 and Diamentor ED) was used to determine radiation exposure doses. Dose va- lues such as dose-area products(DAP, cGycm 2) and enter skin dose(ESD, mGy) were recorded on-line. The effective dose(ED, mSv) was estimated by Monte-Carlo conversion coefficient. Results In this study, the ranges of three items and their median radiation exposure doses were:①DAP 1 250～ 47 991 cGycm 2, 7 334 cGycm 2,②ESD 62～ 1 341 mGy,437 mGy,③ED 1.75～67.19 mSv,10.27 mSv. The contribution to total dose was (26.7%±14.4%) by fluoroscopy,and (73.3%±14.4%) by radiograph respectively. The radiation exposure in lung cancer infusion chemotherapy was larger than that in emptysis embolisation therapy. Conclusion When patients receiving large dose radiation exposure during a chest IVR procedure, the best method of decreasing patients X-ray exposure is to reduce total radiograph frames.

关 键 词：X射线辐射 患者 肺部 介入治疗 

分 类 号：R814.3[医药卫生—影像医学与核医学] R144[医药卫生—放射医学]