五种介入程序中职业人员眼晶状体辐射剂量水平的评估  

Assessment of the Eye Lens dose to Working Operator in Five Types of Interventional Fluoroscopic Procedures

作　　者：薛娴[1] 尉可道[1] 赵洪峰 徐辉[1] 王建超[1] 岳保荣[1] xian;WEI Ke - dao;ZHAO Hong - feng;XU Hui;WANG Jian - chao;YUE Bao - rong.(National Institute for Radiological Protection, China CDC, Beijing 100088 China.)

机构地区：[1]中国疾病预防控制中心辐射防护与核安全医学所放射治疗设备质量控制实验室,北京100088

出　　处：《中国辐射卫生》2017年第4期390-394,共5页Chinese Journal of Radiological Health

基　　金：国家科技支撑计划(2006BA106B03)

摘　　要：目的评估五种临床介入程序中,职业人员眼晶状体所受辐射剂量水平。方法选择四家医院进行五种介入程序实验,将光致发光剂量计(OSL,材料Al2O3:C)分别佩戴在介入职业人员的眼睛附近,记录治疗过程中透视时间、累积剂量和剂量面积乘积(DAP,Dose-Areas Product)等参数,测量用所得的个人剂量当量Hp(0.07)值估算不同程序治疗过程中不同术者的左眼,右眼以及两眼中间的眼晶状体剂量,并与治疗过程的记录值做统计学分析。结果统计计算介入职业人员眼晶状体剂量,五种介入程序-冠状动脉造影(CA,Coronary Angiography)、冠状动脉成形术+植入术(PTCA+PCI,Percutaneous Transluminal Coronary Angioplasty and Percutaneous Coronary Intervention)、脑动脉瘤、心脏起搏器、心脏射频消融,年平均当量剂量分别为15.12、11.59、8.64、36.10、12.78 m Sv。其中操作者在做起搏器治疗时眼晶状体受辐射剂量最高。结论职业人员在起搏器治疗时所受剂量超过国际放射防护委员会(ICRP)最新推荐的眼晶状体剂量限值(20 m Sv)。同时通过统计学分析得,不同的治疗类型、透视时间、累积剂量、DAP,职业人员的眼晶状体剂量也不同。因此,介入职业人员应尽量减少操作时间,加强对眼晶状体的防护。Objective To report estimated radiation dose to the eye lens of the interventionalist from five procedures.Methods The radiation doses to the eye lens for five interventional radiology fluoroscopic systems were measured by using OSLs（Optically Stimulated Luminescence） dosimetry calibrated in Hp（0.07）.For the eyes,the OSLs are positioned to the right,left and middle sids.Meanwhile,fluoroscopy times,accumulated doses,and DAPs（Dose-Area Product） et.al were recorded for statistical analysis.Results The annual eye lens doses estimated for the operator with the highest workload according to the measurements and the system＇s log book were 15.12 mSv in CA（Coronary Angiography）,11.59 mSv in PTCA（Percutaneous Transluminal Coronary Angioplasty） and PCI（Percutaneous Coronary Intervention）,8.64 mSv in Cerebral aneurysm,36.10 mSv in Pacemaker Therapy,12.78 mSv in Radiofrequency ablation.In Pacemaker Therapy the dose of equivalent of eye lens was the highest in he five procedures.The eye lens doses were different in different procedures,fluoroscopy times,accumulated doses and DAPs.Conclusion The eye lens dose of operators in Pacemaker Therapy will receive an annual equivalence dose of more than 20 mSv as recommended by the ICRP provided by the current study.Attention should be paid to the protection of the eyes of operators.

关 键 词：介入治疗 眼晶状体剂量 辐射防护 

分 类 号：R144.1[医药卫生—公共卫生与预防医学]