C型臂X射线机在微创治疗不稳定性粗隆间骨折手术中的放射防护分析  

Radiological Protection Analysis of C-arm X-ray Machine in Minimally Invasive Surgery for Unstable Intertrochanteric Fractures

作　　者：宗治国[1] 苏峰[1] 刘肃[1] 马朋朋[1] 张志敏[2] 赵一洁[3] 张鑫[1] 李伟[1] ZONG Zhiguo;SU Feng;LIU Su;MA Pengpeng;ZHANG Zhimin;ZHAO Yijie;ZHANG Xin;LI Wei(Department of Orthopeadic Surgery,The First Affiliated Hospital of Hebei North University,Zhangjiakou Hebei 075000,China;CT Center,The First Affiliated Hospital of Hebei North University,Zhangjiakou Hebei 075000,China;Hebei North College,Zhangjiakou Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院骨外科,河北张家口075000 [2]河北北方学院附属第一医院CT中心,河北张家口075000 [3]河北北方学院,河北张家口075000

出　　处：《中国医疗设备》2020年第3期80-83,共4页China Medical Devices

基　　金：河北省卫生和计生委员会2017年医学科学研究重点课题计划(20170186)。

摘　　要：目的分析C型臂X射线机在微创治疗不稳定性粗隆间骨折手术中的放射剂量并提出防护策略。方法使用X、γ射线剂量仪检测C型臂X射线机下手术室相关医务人员头部、颈部、胸部、腹部和手部辐射剂量水平,比较上位机型和下位机型C型臂X射线机对医务人员上述部位的辐射剂量差异;使用辐射剂量巡测仪分别测量有防护措施手术间和无防护措施手术间的门、窗、墙及楼下辐射剂量水平,并比较手术室放射的防护效果。结果上位机型C型臂X射线机最大辐射剂量部位为手部;下位机型C型臂X射线机最大辐射剂量部位为腹部。使用上位机型手术时头部、颈部、胸部受到的辐射水平均明显(P<0.05)高于下位机型。无防护房间门外、窗外、墙体射线辐射剂量水平均明显(P<0.05)高于加防护的门外、窗外、墙体射线辐射剂量。结论做好手术室防护是避免医务人员接受射线损害的关键措施,在条件允许的情况下尽量使用下位机型C型臂X射线机以减少射线对人体的伤害。Objective To study and analyze the radiation problems of C-arm X-ray machine in minimally invasive surgery for unstable intertrochanteric fracture and to propose the protective strategy.Methods The radiation dose level of head,neck,chest,abdomen and hand of the medical personnel in the operating room under the C-arm X-ray machine was measured by X-ray andγ-ray dosimeters.The radiation dose difference between the upper and the lower C-arm X-ray machine was compared.The radiation dose levels of doors,windows,walls and downstairs of the operating room with and without protective measures were measured by radiation dose patrol instrument,and the radiation protection effects of the operating room were compared.Results The upper C-arm X-ray machine caused the maximum radiation dose in the hand;the lower C-arm X-ray machine caused the maximum radiation dose in the abdomen.The radiation level of the head,neck and chest of upper C-arm X-ray machine was significantly higher than that of the lower model(P<0.05).The radiation dose level outside the door,window and wall of unprotected room was significantly higher than that of protected room(P<0.05).Conclusion To protect the operating room is the key measure to avoid the radiation damage of medical staff.If conditions permit,the lower model C-arm X-ray machine shall be used as much as possible to reduce the harm of radiation to human body.

关 键 词：C型臂X射线机 骨科 微创手术 放射防护分析 

分 类 号：R318[医药卫生—生物医学工程] R144[医药卫生—基础医学]