心血管介入患者的医疗照射水平  

Level of Medical Radiation Received during Cardiovascular Intervention

作　　者：刘虎 乔洪梅 毛翠平[2] 

机构地区：[1]嘉兴市第二医院放射科,浙江嘉兴314000 [2]西安交通大学医学院第一附属医院放射科,陕西西安710061

出　　处：《环境与职业医学》2012年第5期312-315,共4页Journal of Environmental and Occupational Medicine

摘　　要：[目的]分析心血管介入诊疗中患者的医疗照射水平,探讨相应的辐射防护对策。[方法]回顾性分析262例共4组患者(组1:单行冠状动脉造影术;组2:冠状动脉造影+球囊预扩张和支架置入术;组3:心脏起搏器置入、更换术;组4:电生理检查+射频消融术),测算不同类别心血管介入诊疗的剂量与面积之积(dose-area product,DAP,mGycm2)和空气比释动能(air kerma,AK,mGy),用Monte-Carlo转换系数从剂量与面积之积估算有效剂量。[结果]DAP值、AK值、有效剂量均以组2最高,分别为(131941.91±112242.64)mGycm2、(1131.07±635.75)mGy、(18.47±15.71)mSv;均以组3最低,分别为(32045.50±57475.17)mGycm2、(158.98±379.50)mGy、(4.49±8.05)mSv;各组中个体的辐射暴露差异均较大。透视时间以组4最长,为(17.03±3.35)min。摄影帧数以组2最多,为(787.12±316.53)帧;组4最少,仅为(3.55±6.27)帧。[结论]不同类别心血管介入诊疗,患者的医疗照射水平差异较大。患者所受辐射剂量较高,应采取适当防护措施,有效防范患者可能受到的潜在电离辐射危险。[ Objective ] To measure the medical radiation level received by patients during diagnosis and treatment of cardiovascular intervention, and probe into the countermeasures for protection. [ Methods ] A total of 262 cases were divided into 4 groups by the type of cardiovascular interventions they received （Group 1, single coronary angiography; Group 2, coronary angiography ± coronary artery pre-expansion and stem implantation; Group 3, pacemaker implantation and replacement; Group 4, electrophysiology examination and radio frequency ablation）. Dose-area product （DAP, mGycm2） and air kerma （AK, mGy） were analyzed retrospectively. Effective dose was estimated by Monte-Carlo conversion coefficient from DAP. [ Results ] DAP, AK and effective dose were highest in Group 2, （131941.91 ± 112242.64） mGycm2, （1 131.07 ± 635.75） mGy, and （18.47 ± 15.71） mSv, respectively; and were lowest in Group 3, （32045.50 ± 57475.17） mGycm2, （158.98 ± 379.50） mGy, and （4.49 ± 8.05） mSv, respectively. There were significant differences in individual radiation exposure among these four groups. Fluoroscopy time was longest in Group 4, （17.03 ± 3.35） min. Number of radiography frame was most in Group 2 （787.12 ± 316.53） and least in Group 4 （3.55 ± 6.27）. [ Conclusion ] There is a great difference in the medical radiation level among patients who receive different cardiovascular interventions. As high doses of radiation are received during interventional diagnosis and treatment, appropriate protective measures are necessary to prevent them from potential risk of ionizing radiation.

关 键 词：心血管介入 辐射剂量 辐射防护 剂量与面积之积 

分 类 号：R144[医药卫生—公共卫生与预防医学]