基于FMECA方法的高剂量率后装放疗中人因可靠性研究  

Human reliability in high dose rate afterloading radiotherapy based on FMECA

作　　者：邓君[1] 范瑶华[1] 岳保荣[1] 尉可道[1] 任福利 

机构地区：[1]辐射防护与核应急中国疾病预防控制中心重点实验室,中国疾病预防控制中心辐射防护与核安全医学所,北京100088 [2]内蒙古自治区卫生厅卫生监督所

出　　处：《中华放射医学与防护杂志》2012年第3期314-317,共4页Chinese Journal of Radiological Medicine and Protection

基　　金：国家科技支撑计划项目（2006BA106803）

摘　　要：目的研究高剂量率（highdoserate，HDR）后装放疗中的人因可靠性，找出人因风险较高的操作并提出合理可行的控制措施，从而提高HDR后装放疗的临床应用安全。方法采用现场调研、流程分析和专家评分的方法获得基础数据，并基于失效模式、影响及危害度分析（failuremode，effectsandcriticalityanalysis，FMECA）方法对HDR后装治疗实施中的人因可靠性进行研究。结果建立了HDR后装放疗的FEMCA人因分析模式，得出实施HDR后装放疗177步骤中相对风险高的有25个，占14．1％。结论采用FMECA方法研究HDR后装放疗人因失误是可行的。针对较高风险步骤提出了降低人因失误的措施，为提高HDR后装放疗的临床应用安全提供了重要参考依据。Objective To put forward reasonable and feasible recommendations against the procedure with relative high risk during the high dose rate （HDR） afterloading radiotherapy, so as to enhance its clinical application safety, through studying the human reliability in the process of carrying out the HDR afterloading radiotherapy. Methods Basic data were collected by on-site investigation and process analysis as well as expert evaluation. Failure mode, effect and criticality analysis （FMECA） employed to study the human reliability in the execution of HDR afterloading radiotherapy. Results The FMECA model of human reliability for HDR afterloading radiotherapy was established, through which 25 procedures with relative high risk index were found, accounting for 14. 1% of total 177 procedures. Conclusions FMECA method in human reliability study for HDR afterloading radiotherapy is feasible. The countermeasures are put forward to reduce the human error, so as to provide important basis for enhancing clinical application safety of HDR afterloading radiotherapy.

关 键 词：高剂量率 后装放疗 人因失误 失效模式 影响及危害度分析方法 

分 类 号：R142[医药卫生—公共卫生与预防医学] R730.5