悬吊防护屏对介入医师最佳防护方案的体模研究  

The optimal radiation protective protocol of ceiling- suspended lead shield for interventional radiologists: a phantom study

作　　者：陈子满 黄美萍[2] 罗纯[2] 黄斯凡[3] 谈文开[2] 刘勇东[2] 胡天宇[2] 

机构地区：[1]汕头大学医学院,广东省人民医院,广东省医学科学院 [2]广东省医学科学院介入导管室,广东汕头515041 [3]西门子(中国)有限公司

出　　处：《介入放射学杂志》2015年第7期637-641,共5页Journal of Interventional Radiology

基　　金：NSFC-广东联合基金重点支持项目(U1401255);国家"十二五"科技支撑项目(2011BAI11B22);广东省科技支撑计划项目(2009B030801257)

摘　　要：目的探讨悬吊防护屏规格及摆放位置对介入手术中第一及第二术者辐射防护效果,为选择悬吊防护屏最佳辐射防护方案提供科学依据。方法在第一及第二术者站位,从地面20 cm至180 cm处,每隔20 cm放置一个个人计量仪。投照体位选择正位与左侧位。悬吊防护屏为铅玻璃（简称玻璃式）与铅玻璃下接铅橡胶皮（简称混搭式）两种。防护屏摆位分别为靠近术者、远离术者、在术者左侧及贴近球管4种。测量2种投照体位下,不同防护屏规格与摆位在第一及第二术者位9个高度的实时辐射剂量率,计算剂量屏蔽率。结果两种防护屏防护效果接近,以玻璃式略优。对于第一术者,正位投照时以近术者摆位的防护效果最佳,侧位投照则以术者左侧摆位的防护效果最好;对于第二术者,正及侧位投照均以近术者摆位防护效果最优。在最佳摆位情况下：正位投照时第一术者在120 cm高度、侧位投照时第一及第二术者各高度仍可检测到较高的辐射剂量率;第一与第二术者总体接受的辐射剂量接近;第一术者的剂量屏蔽率除正位120 cm高度稍低（玻璃式为60.11%,混搭式为39.89%）外,其余各点均高达93%以上,第二术者剂量屏蔽率为57%~97%;侧位屏蔽率整体略高于正位屏蔽率。结论两种防护屏防护效果接近,均能取得较好的防护效果,但正位投照时第一术者的120 cm高度及侧位投照时2位术者的各高度辐射剂量率仍相对较高,需加强对120 cm高度的辐射防护,并尽量少用侧位投照。Objective To evaluate the radiation protective efficacy of different types and the positions of ceiling- suspended lead shield to the principal and assistant interventional operators in order to provide a scientific basis for the selection of optimal scheme in using ceiling- suspended lead shield. Methods At the principal and assistant interventional operators＇ standing places the personal dose- measuring instruments were set up, which were placed at the height of 20 cm to 180 cm above the ground with an interval distance of20 cm between each other. The postero- anterior（PA） projection and left lateral projection were used. The ceiling- suspended protection lead shields included lead glass（glass type） and lead glass with connected lead flexible stripe below（mixed type）. The placed sites of the protection lead- shields were close to the principal operator, away from the principal operator, on the left side of the principal operator and close to the X- ray tube respectively. The radiation doses of PA projection and left lateral projection were determined. The real-time radiation dose rate and dose shielding rate at the nine measuring positions for the principal operator and assistant operator were separately calculated. The results were analyzed. Results The radiation protection of the glass type was slightly superior to that of the mixed type, but the difference was not significant. The principal operator was best protected when the shield was positioned close to him in the PA projection, and for left lateral projection the principal operator was best protected when the shield was positioned on his left side. For the assistant operator, the optimal protection was obtained when the shield was positioned close to him in both PA and left lateral projection. In the optimal position of ceiling- suspended lead shield, the highest radiation dose rate（0.71 m Sv/h in glass group and 1.07 m Sv/h in mixed group） was recorded on the principal operator at the height of 120 cm at PA projection, and higher radi

关 键 词：介入放射 辐射剂量 辐射防护 

分 类 号：R144[医药卫生—公共卫生与预防医学]