经皮冠脉介入术中术者头颈部辐射强化防护效果研究  

The effect of enhanced radiation protection of head and neck for operators during coronary intervention

作　　者：钱海[1] 丁科权 楼钶楠[1] 岑泽民[1] 章璐幸[2] QIAN Hai;DING Kequan;LOU Kenan;Cen Zemin;ZHANG Luxing(Department of Cardiology,Ningbo Medical Center Lihuili Hospital,Ningbo 315040,China)

机构地区：[1]宁波市医疗中心李惠利医院心血管内科,315040 [2]浙江医药高等专科学校实验室与资产管理处

出　　处：《心电与循环》2021年第1期6-10,16,共6页Journal of Electrocardiology and Circulation

摘　　要：目的分析经皮冠脉介入过程术者头颈部所受辐射剂量和强化头颈部防护效果。方法用仿真人体模型进行曝光,采集两位术者左眼、左腮腺颌下腺、甲状腺在不同投照位和不同防护条件下的体表入射剂量率,计算不同防护下的射线屏蔽率。结果无防护时,两位术者头颈部的体表入射剂量率均较高,多数投照位下,第一术者左眼、左腮腺、左颌下腺和甲状腺部位体表入射剂量率均高于第二术者,差异均有统计学意义(均P<0.05)。第一术者最高为(5833.1±23.1)μGy/h(左眼、左足位),第二术者最高为(4826.8±27.2)μGy/h(甲状腺、左足位)。给予的防护措施越强,体表入射剂量率越低(P<0.05),射线屏蔽率越高。结论经皮冠脉介入诊疗中,术者头颈部的辐射剂量受站位及造影投照位影响,应加强头颈部防护。Objective To investigate radiation exposure dose in head and neck of operator and the effect of enhanced protective shield during coronary intervention.Methods Radiation exposures were carried out on an anthropomorphic phantom at multiple projections and the entrance surface dose(ESD)rates in left eye,left parotid-submandibular gland and thyroid of two operators were measured under different protection conditions.The shielding rate of X-ray under different protection conditions was calculated.Results The ESD rates of head and neck were higher for both operators without radiation protection.Under most radiographic projections,the ESD rates in left eye,left parotid-submandibular gland and thyroid were significantly higher in primary operator than in assistant(P<0.05).The highest ESD rate was measured in left eye[(5833.1±23.1)μGy/h]for primary operator and in thyroid[(4826.8±27.2)μGy/h]for assistant under left-caudal projection.The ESD rate was decreasing and X-ray shielding rate was increasing as the protective measure enhanced.Conclusion The radiation exposure dose of head and neck is influenced by operator standing position and radiographic projections.The head and neck shield should be enhanced during coronary intervention.

关 键 词：经皮冠脉介入 头颈部 体表入射剂量率 辐射防护 

分 类 号：R541.4[医药卫生—心血管疾病] R142[医药卫生—内科学]