肝恶性肿瘤125I放射性粒子植入治疗后辐射剂量监测及防护对策的前瞻性研究  

The prospective study of radiation dose monitoring and protective measures after 125I radioactive seeds implantation for liver cancer

作　　者：景元明[1] 徐昌良[1] 章俞 陈兴美[1] 林方琴 孙爱静 Jing Yuanming

机构地区：[1]浙江省绍兴市人民医院(浙江大学绍兴医院),312000 [2]浙江思格一医疗科技有限公司,312000

出　　处：《浙江临床医学》2020年第2期170-172,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省绍兴市公益性技术应用研究项目(2018C30109);CSC0临床肿瘤学研究基金(YHR2016-131)。

摘　　要：目的检测肝恶性肿瘤患者在B超引导下125I粒子植入治疗后不同当量铅胶皮防护前后的辐射剂量,探讨恰当的防护措施.方法2016年12月至2018年12月,采用自身前后对照的前瞻性研究方法对符合入选标准的30例肝恶性肿瘤患者行B超引导下125I粒子植入治疗,处方剂量120~140Gy.术后用x-γ射线巡测仪检测距离防护及0.125/0.175/0.25/0.35mmPb屏蔽条件下的辐射剂量率,比较不同铅当量铅胶皮的防护效果.结果无防护下肝脏体表辐射剂量率均值为(322.62±332.25)μSv/h;辐射剂量率随着放射源距离的增大而衰减,2m处为本底量.在0.125mmPb铅当量屏蔽距放射源1m、0.175mmPb铅当量屏蔽距放射源0.5 m、0.25mmPb铅当量屏蔽体表条件下的辐射剂量率最高值分别为0.08μSv/h、0.10μSv/h、0.09μSv/h.0.125mmPb铅当量屏蔽下检测到体表最大辐射剂量率为11.1μSv/h.结论在B超引导下125I粒子植入治疗肝恶性肿瘤术后应积极采取检测及防护措施,本组病例患者采用0.125mmPb屏蔽防护方式,可使长期密切接触的医护人员及亲属达到防护安全要求.Objective To detect the radiation dose of different equivalent lead rubber before and after the treatment of liver malignant tumors with 125I seed implantation guided by B ultrasound,and to explore appropriate protective measures.Methods From December 2016 to December 2018,30 patients with hepatic malignant tumors who met the inclusion criteria were treated with 125I seed implantation guided by B ultrasound.The prescription dose was 120—140 Gy.After operation,x/7—ray detector was used to detect the radiation dose rate under the condition of distance protection and 0.125/0.175/0.25/0.35mmPb shielding.The protective effects of different lead equivalent lead rubber were compared.Results The average radiation dose rate of liver surface under unprotected condition was(322.62±332.25)fx Sv/h.The radiation dose rate decreased with the increase of radiation source distance and reached the background at 2 meters.Under the conditions of 0.125mmPb lead equivalent shielding distance of I meter,0.175mmPb of 0.5 meter,0.25mmPb on liver surface,the maximum radiation dose rates were 0.08μSv/h,0.10μSv/h and O.09μSv/h,respectively.The maximum radiation dose rate on the liver surface was 11.1μSv/hat the 0.125mmPb lead equivalent shield.Conclusion Protective measures should be taken actively after the implantation of 125I seeds guided by B ultrasound in the treatment of hepatic malignant tumors.The 0.125mmPb shielding method has been adopted by this group of patients,which can make the long-term close contact of medical staff and relatives meet the protection safety requirements.

关 键 词：肝肿瘤 辐射剂量 辐射检测 碘放射性同位素/治疗应用 

分 类 号：R73[医药卫生—肿瘤]