冠状动脉介入诊疗中不同血管机型对操作者所受辐射剂量的影响  

The influence of different imaging systems on radiation dose to operator in percutaneous coronary intervention

作　　者：胡文豪[1] 王智廷[1] 曹国全[1] 黄伟剑[1] 郑祥武[1] HU Wenhao WANG Zhiting CAO Guoquan HUANG Weijian ZHENG Xiangwu.(Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015)

机构地区：[1]温州医科大学附属第一医院介入科,浙江温州325015

出　　处：《温州医科大学学报》2017年第8期561-565,共5页Journal of Wenzhou Medical University

基　　金：浙江省自然科学基金资助项目(Y17H180046)

摘　　要：目的:探讨冠状动脉介入诊疗过程中不同型号的血管机对第一及第二术者位置辐射剂量的影响。方法:采用冠状动脉造影过程中常用的7个体位,桡动脉途径,对标准仿真人模体进行曝光采集。测量不同高度不同采集体位时,专用机和公用机在有无床旁防护屏情况下第一及第二术者位置的体表入射剂量率。采用配对t检验比较不同机型第一及第二术者体表入射剂量率的差异。结果:无床旁防护情况下,125cm和155cm高度时,公用机的体表入射剂量率(除第一术者155cm高度足位、右足位及第二术者125cm高度右足位,155cm高度足位、右足位外)都大于专用机(P<0.05)。有床旁防护情况下,125cm和155cm高度时,在足位、右足位、左侧位及右侧位2种机型第一术者都未测得体表入射剂量,公用机在头位未测得体表入射剂量;公用机第一术者125cm、155cm高度时左足位的体表剂量率都大于专用机(P<0.05);而专用机在125cm处头位及左头位和155cm处头位的体表入射剂量率大于公用机(P<0.05);对于第二术者,公用机的体表入射剂量率(除右足位外)都大于专用机的体表入射剂量率(P<0.05)。结论:冠状动脉介入诊疗过程中,使用公用机时操作者所受剂量大于使用专用机时操作者所受剂量。在条件允许情况下尽可能采用专用机来进行冠状动脉介入诊疗过程,以减少操作者所受辐射剂量。Objective： To discuss the effect of different imaging systems on radiation to the first and second operator s position dose in percutaneous coronary intervention. Methods： In this study, the measurements of the first and second operator＇s surface entrance dose rate in 125 cm and 155 cm height were obtained in no and have radiation protection separately through transradial approach by special and public imaging system. The paired t test was used for statistical analysis of dose rate arithmetic mean values. Results： The operator＇s surface entrance dose rate of public imaging system （except for the foot and right foot position of first operator in 155 cm height; the right foot position in 125 cm height and foot and right foot position in 155 cm height of second operator） was significantly higher than that of special imaging system in no bedside protection situation. In a bedside protection situation, the operator＇s surface entrance dose rates of foot, right foot, left and right position of first operator in 125 and 155cm height in both systems were not detected. The dose rates of the left foot position of public imaging system in 125 cm and 155 cm height were higher than that of special imaging system. The dose rates of head and left head position in 125 cm height and head position in 155 cm height of special imaging system were higher than that of public imaging system. For second operator, the operator＇s surface entrance dose rates of public imaging system were significantly higher than that of special imaging system. Conclusion： The operator＇s radiation dose of public imaging system is significantly higher than that of special imaging system. In daily work the special imaging system should be used as much as possible so as to reduce the operators＇ radiation dose.

关 键 词：冠状动脉介入诊疗 不同机型 体表入射剂量率 辐射防护 

分 类 号：R14[医药卫生—公共卫生与预防医学]