剂量面积乘积数据库在心血管介入职业辐射防护中的价值分析  

Practicable value of DAP （ dose-area product） database in occupational radiation protection in cardiovascular interventional procedures

作　　者：丁海岭[1] 王永春[1] 江薇[1] 

机构地区：[1]上海市第二军医大学附属长海医院放射科,200433

出　　处：《中华放射医学与防护杂志》2017年第8期623-625,629,共4页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的 评价剂量面积乘积（DAP）数据库对降低心血管介入人员辐射风险的应用价值。方法 回顾性分析数据库2016年4月1日至6月30日全部1 858例心血管介入病例，收集受检者体重指数（BMI）、透视时间和DAP资料。成像设备分组（影像增强器和平板探测器FPD），对冠状动脉造影术（CAG）和经皮冠状动脉介入治疗术（PCI）资料比较分析。结果 影像增强器和平板探测器各组CAG的透视时间和DAP值分别为（3.26±2.59）、（3.00±2.89） min、（1 938±1 296）和（3 718±2 859）μGy ·m2，PCI的透视时间和DAP值为（17.81±12.71）、（21.99±15.91） min、（8 899±7 032）和（19 526±14 134）μGy ·m2。成像设备分组同类手术比较，CAG和PCI的DAP差异均有统计学意义（t=-10.664、11.239，P〈0.05）。平板探测器PCI总DAP值和透视DAP值分别为4 881 484.50和3 596 755.60 μGy ·m2。结论 FPD的CAG和PCI采集剂量偏高，FPD成像系统辐射剂量明显高于Ⅱ成像系统，降低PCI手术透视时间是降低手术辐射风险的关键。DAP数据库在心血管介入辐射防护中为及时发现辐射剂量差异和变化提供了快速、便捷和充分的客观数据。Objective To evaluate the efficacy of the DAP database in reducing radiation hazards during cardiovascular intervention.Methods The study conducted a retrospective analysis of all consecutive cardiovascular cases in the database from April 1st,2016 to June 30th,2016.Based on the imaging systems,an image intensifier （Ⅱ） and a flat panel detector （FPD）,the cases of patients undergoing coronary angiography （CAG） and percutaneous coronary interventions （PCI） were collected to observe Body Mass Index （BMI）,fluoroscopy time （FT） and dose area product （DAP）. Results The FT and DAP values in CAG were （3.26±2.59） min and （1 938±1 296）μGy·m2 for the Ⅱ system and （3.00±2.89） min and （3 718±2 859）μGy·m2 for the FPD system,respectively,whereas,the FT and DAP values in PCI were （17.81±12.71） min and （8 899±7 032）μGy·m2 for the Ⅱ system and （21.99±15.91） min and （19 526±14 134）μGy·m2 for the FPD system,respectively.The differences in DAP values （x±s） for CAG and PCI between the angiography systems were significant （t=-10.664,11.239,P〈0.05）.The DAP and total DAP values during PCI for fluoroscopy from the FPD system were 3 596 755.60 and 4 881 484.50 μGy·m2,respectively. Conclusions The DAP values in CAG and PCI using FPD system are much higher than the relevant data.The use of an FPD system resulted in higher DAP values compared to the Ⅱ system in cardiovascular interventional procedures.Reduction in fluoroscopy time may decrease radiation hazards during PCI.The DAP database allows for a fast,convenient and enough objective data to discovery timely difference and variation in dose in cardiovascular interventional procedures.

关 键 词：剂量面积乘积 心血管介入 数据库 

分 类 号：R146[医药卫生—公共卫生与预防医学]