冠心病介入诊疗中透视与电影辐射剂量率对比分析  

Radiation dose rate received by patients with coronary heart disease during interventional management: comparison between fluoroscopy and movies

作　　者：刘伟宾[1] 黄连军[1] 郭久芳[1] 王弋辉 靳国梁[1] 李羽加 申涛[1] 张伯麟 张珅[1] 陈健[1] 

机构地区：[1]首都医科大学附属北京安贞医院介入诊疗科,100029

出　　处：《介入放射学杂志》2015年第6期524-527,共4页Journal of Interventional Radiology

摘　　要：目的研究冠心病患者介入诊疗中DSA设备显示的实时辐射剂量率,为医务人员合理控制辐射剂量提供依据。方法随机抽取2014年9月采用美国通用公司DSA机介入诊疗的冠心病患者30例,对术中DSA机由透视模式转换为电影模式时各自序列显示的辐射剂量率进行对比分析。结果透视辐射剂量率为18.5~212.0 m Gy/min,均值为（114.7±42.1）m Gy/min;电影辐射剂量率为216~1 691 m Gy/min,均值为（970.1±298.4）m Gy/min。透视与电影辐射剂量率总体均值之比为1︰8.5。数字平板探测器面积越大,辐射剂量率均值越大,电影辐射剂量率均值较透视辐射剂量率均值增高趋势越明显;透视辐射剂量率均值较电影辐射剂量率均值低,差异显著。结论医务人员在冠心病介入诊疗中应合理选择DSA设备类型,密切观察动态实时显示的辐射剂量率,及时调整检查模式及可控参数,即刻评估可能致患者放射损伤的剂量水平,合理控制辐射剂量,以降低电离辐射对人体健康产生的辐射效应。Objective To determine the real time radiation dose rate displayed on DSA equipment in interventional management for patients with coronary heart disease in order to provide medical staff with useful basis to reasonably control the radiation dose. Methods A total of 30 patients with coronary heart disease, who received interventional treatment at authors＇ hospital in September 2014 with a GE DSA unit,were randomly selected. Intraoperative radiation dose rates when fluoroscopy was converted to movies, which were displayed on DSA at respective sequence, were determined, and the results were analyzed and compared. Results The fluoroscopy radiation dose rate ranged from 18.5 to 212.0 m Gy/min, the mean value was（114.7±42.1） m Gy/min; while the radiation dose rate of movies varied from 216 to 1 691 m Gy/min, with a mean value of（970.1±298.4） m Gy/min. The overall mean fluoroscopy-to-movies radiation dose ratio was 1 ∶8.5. The larger the digital flat panel detector area was, the bigger the mean radiation dose rate would be and the more obvious increase in the mean radiation dose rate of movies than that of the fluoroscopy would be observed; the mean radiation dose rate of fluoroscopy was lower than that of movies, and the difference was significantly. Conclusion During the performance of coronary intervention, the medical staff should make reasonable choice of the equipment and closely observe the dynamic real-time display of the radiation dose rate, promptly adjust the inspection mode and the controllable parameters when it is needed, make immediate evaluation of dose level that might cause radiation injury to the patient, and reasonably control the radiation dose to reduce the effects of ionizing radiation on human health.

关 键 词：冠心病 介入诊疗 辐射剂量率 辐射防护 

分 类 号：R541.4[医药卫生—心血管疾病]