不同路入途径行冠状动脉造影时术者手部受照剂量的对比分析  

COMPARISON OF OPERATOR’S HAND EXPOSURE DOSE DURING CORONARY ANGIOGRAPHY BY RADIAL AND FEMORAL APPROACH

作　　者：赵军[1] 李秋香[2] 李斌[3] 王卫[3] 李红环[2] 王圣[3] 廖旺[3] 陈美丹[1] 吴宁[1] 

机构地区：[1]海南省人民医院放射科,海口570311 [2]海南省疾病预防控制中心放射防护与职业卫生所 [3]海南省人民医院心内科

出　　处：《现代预防医学》2011年第15期3097-3098,3102,共3页Modern Preventive Medicine

基　　金：海南省卫生厅科研项目(琼卫2010-4)

摘　　要：[目的]对比测定经股动脉和桡动脉路入途径行冠脉造影时第一术者手部的受照剂量,为心血管介入的辐射防护提供参考依据。[方法]在履行知情告知并尊重患者意愿的情况下,由经验丰富的心血管科介入专家左手背固定热释光剂量计,对体重和胸部体厚大致相同的60例男性患者行冠脉造影,按其血管途径分为桡动脉组32例和股动脉组28例,桡动脉途径组患者行Allen’s试验呈阳性,选右桡动脉入径;股动脉途径组按常规方法操作,采用热释光剂量仪分别测量不同途径下第一术者手部受照剂量。所得数据资料,采用SPSS10.0软件进行统计学分析,P﹤0.05为差异有统计学意义。[结果]两组造影途径的患者体重、胸部体厚、透视时间和曝光帧数没有明显差异,但术者手部剂量桡动脉组(54.65±48.18uGy)明显高于股动脉组(31.17±13.92uGy),两组结果进行比较,差异有统计学意义(P﹤0.05)。[结论]桡动脉途径因为成功率高、并发症少成为冠心病介入治疗的首选途径同时,介入医师所接受的辐射剂量较大,应该采取有效措施来加强对手术者和患者的辐射防护。[Objective]The aim of this study was to measure and comparison of operator’s hand exposure dose during coronary angiography by radial and femoral approach,meanwhile these exposure dose data obtained from the study can supply reference on radiation protection during coronary angiography and interventional procedures.[Methods]60 male patients who fulfilled the criteria of weight and chest thickness were scheduled for elective coronary angiography. After informed consent was obtained,the catheterization procedure was performed randomly either from a femoral or a radial approach by the same operator with vast experience. The radial approach was performed only in 32 patients who had a normal Allen’s test,through the right radial artery. The femoral approach was performed in 28 patients through the right femoral artery based on femoral pulse strength;The principal operator’s hand radiation exposure was assessed from interventional procedures using thermoluminescence located on the back of left-hand. Comparisons of dose data were performed with SPSS10.0 for windows software,a P value ﹤0.05 was considered to be significant.[Results]There were no significant differences between groups in the weight and chest thickness of patients,fluoroscopy time as well as exposure frames. But radiation exposure of operator’s hand was significantly higher using the radial route when compared with the femoral route during coronary angiography,54.65±48.18 uGy VS 31.17±13.92 uGy. Statistical significance was considered as P-value ﹤0.05.[Conclusion]Although the transradial coronary angiography widely be performed with a high success rate,low rate of complication,increased radiation exposures of operators through the radial approach is currently a growing problem for the interventional cardiologist health. Some more effective protection should be taken to decrease the X-ray radiation dose accepted by operators and patients.

关 键 词：冠状动脉造影 桡动脉 股动脉 辐射剂量 评价研究 

分 类 号：R445[医药卫生—影像医学与核医学]