心血管介入手术中操作者职业照射的临床调查  

Clinical Investigation Study on Occupational Exposure of Operators During Cardiovascular Intervention

作　　者：丁艳秋[1] 孙晶星[1] 焦玲[1] 冯鑫[1] 张晓东[1] 张仲健[1] 武权[1] 张文艺[1] 

机构地区：[1]中国医学科学院放射医学研究所,天津300192

出　　处：《中国辐射卫生》2012年第3期261-263,共3页Chinese Journal of Radiological Health

基　　金：中国医学科学院放射医学研究所探索基金

摘　　要：目的调查心血管介入手术中操作者的有效剂量。方法利用热释光方法对某省属三级甲等医院进行的24例冠状动脉血管造影术(CA)或者继续行经皮穿刺腔内冠状动脉成形术(PTCA)或者继续行冠状动脉支架植入术(PICAS)和4例起搏器植入术(PT)的操作者进行了体表剂量测定和有效剂量估算。结果在CA、PTCA、PICAS中平均手术时间为(19.2±6.3)min,操作者平均每次手术的有效剂量为(4.1±0.9)μSv,在没有铅衣防护的条件下,为(52.2±15.5)μSv;而PT平均手术时间为(14.1±4.6)min,操作者平均每次手术的有效剂量为(5.5±1.4)μSv,在没有铅衣防护的条件下,为(220±42)μSv。结论应努力提高操作者的技术水平,缩短荧光照射时间,保证医护人员防护设施的配置,以降低操作者的受照剂量。Objective To investigate the personal effective dose of the operator in cardiovascular intervention. Methods Lithium fluoride （LiF） thermoluminescent dosimeters （TLD） were used to carry out personal dose monitoring for the operator. Effective doses of the operator were evaluated in 28 clinical operations. Results The average fluoroscopy time for 24 Coronary angiography （CA） , percutaneous transluminal coronary angioplasty （PTCA） and pereutaneous intracoronary arterial stenting （PICAS） procedures was 19.2 ±6.3 rain, and the average effective dose of the operator per procedure was 4. I ±0. 9μSv （ under protection） and 52.2 ± 15.5 μSv （without protection）. However, for 4 PT procedures, average fluoroscopy time was 14.1 ±4.6 min, and the average effective dose of the operator per operation was 5.5 ± 1.4 μSv （under protection） and 220 ± 42 μSv （ without protection）. Conclusions Reducing fluoroscopy time, femoral artery access to the patients are recommended during interventional procedures. In order to decrease the radiation risk to the lowest level, more advanced equipments should be applied and radiation protection should be fully managed.

关 键 词：心血管介入手术 职业照射 数字减影血管造影(DSA) 热释光剂量计(TLD) 

分 类 号：R815[医药卫生—放射医学]