经皮冠状动脉介入术者不同体位所受辐射剂量特征分析  

Radiation doses accepted by operators in different positions during percutaneous coronary intervention:analysis of radiation distribution characteristics

作　　者：王智廷[1] 郑翔[1] 戴振宇[1] 闻彩云[1] 曹国全[1] WANG Zhiting;ZHENG Xiang;DAI Zhenyu;WEN Caiyun;CAO Guoquan(Department of Cardiology,First Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang Province 325015,China)

机构地区：[1]温州医科大学附属第一医院心内科,浙江325015

出　　处：《介入放射学杂志》2020年第1期21-24,共4页Journal of Interventional Radiology

摘　　要：目的探讨经皮冠状动脉介入诊疗过程中不同防护屏和操作者不同体位时所受辐射剂量的构成特点。方法采用冠状动脉介入诊疗常用7个体位,取桡动脉入路,对标准仿真人模体进行射线曝光,采集测量不同体位无床旁防护、只有悬吊防护屏、只有床旁固定铅裙时第1、第2操作者入射体表剂量。重复测量20次。采用t检验比较不同情况下体表入射剂量值差异,分别计算不同体位不同防护屏屏蔽率。结果第1、第2操作者体表入射剂量在只有床旁固定铅裙时均高于只有悬吊防护屏时(t值1=926.0、376.5、75.8、1329.0、668.0、1148.0、419.5,t值2=102.6、41.1、82.8、539.4、541.8、204.0、43.1),差异均有统计学意义(P<0.05)。不同体位悬吊防护屏对第1操作者体表入射剂量屏蔽率分别为98.31%、93.67%、67.74%、98.63%、99.52%、89.28%、96.10%,床旁固定铅裙对第1操作者屏蔽率分别为10.39%、4.53%、57.67%、0.68%、4.66%、54.38%、9.68%。结论冠状动脉介入诊疗过程中操作者所受辐射剂量主要来源于导管床上方散射辐射,以左足位、左前斜位、足位、右足位、右前斜位最显著;左头位、头位时操作者所受辐射剂量除了来源于导管床上方散射辐射,也有部分来源于导管床下方散射辐射。充分了解各体位时所受辐射剂量构成特征,有助于日常辐射防护有的放矢。Objective To discuss the characteristics of radiation distribution for operators in different positions with different radiation shields during percutaneous coronary intervention(PCI).Methods Seven operator’s positions and radial artery approach often used in PCI were adopted in this study.The standard simulation human body was exposed to X-ray.Under the conditions of different operator’s positions with no bedside protection,with only hanging protective shield or with only bedside fixed lead skirt,the body surface incident doses on the first and second operators in different positions were separately measured,and the measurements were repeated 20 times.Using t test the differences of body surface incident dose under different conditions were compared.The radiation-shielding rates of different protective shields in different positions were separately calculated.Results The body surface incident doses on the first and second operators when only a fixed bedside lead skirt was used were higher than those when only a hanging protective shield was used(t values for first operator=926.0,376.5,75.8,1329.0,668.0,1148.0 and 419.5 respectively;t values for second operator=102.6,41.1,82.8,539.4,541.8,204.0 and 43.1 respectively),the differences were statistically significant(P<0.05).The radiation-shielding rates of ceiling-suspended screen for body surface incident dose for first operator in different positions were 98.31%,93.67%,67.74%,98.63%,99.52%,89.28%and 96.10%respectively;while the radiation-shielding rates of fixed bedside lead skirt for body surface incident dose for first operator in different positions were 10.39%,4.53%,57.67%,0.68%,4.66%,54.38%and 9.68%respectively.Conclusion During PCI,the radiation dose received by the operators mainly comes from the scattered radiation above the catheter-bed,which is more obvious in left foot position,left anterior oblique position,foot position,right foot position and right anterior oblique position.In left head position and head position,the radiation dose received by th

关 键 词：经皮冠状动脉介入治疗 辐射剂量 剂量特征 辐射防护 

分 类 号：R541.1[医药卫生—心血管疾病]