X射线透视下食管支架置入术时患者受照剂量的估算  

The estimation of patient′s exposure dose during esophageal stent placement under X-ray fluoroscopy

作　　者：张琳[1] 杨淑慧[1] 牛菲[1] 闵楠[1] 李贞[1] 李海亮[1] 宋钢[1] 孙伟航 刘涵笑 朱建国[1] ZHANG Lin;YANG Shuhui;NIU Fei;MIN Nan;LI Zhen;LI Hailiang;SONG Gang;SUN Weihang;LIU Hanxiao;ZHU Jianguo(School of Preventive Medicine Sciences(Institute of Radiation Medicine),Shandong First Medical University(Shandong Academy of Medical Sciences),Jinan 250062 China)

机构地区：[1]山东省第一医科大学(山东省医学科学院)预防医学科学学院(放射医学研究所),山东济南250062

出　　处：《中国辐射卫生》2020年第6期590-593,共4页Chinese Journal of Radiological Health

基　　金：山东省自然科学基金联合专项(ZR2016YL020);山东省医学科学院院级科技计划(2016-23)。

摘　　要：目的通过仿真人体模型实验,估算X射线透视下食管支架置入术时患者的受照剂量。方法调查省级三甲医院60例食管支架置入术,记录术中透视时间、管电压、管电流等信息,根据透视时间的长短、累积剂量和DAP的大小将仿真人体模型实验分为3组,在仿真人体模型内的预定孔中放入热释光剂量计,按实验条件分组还原手术过程。根据热释光剂量计测量结果估算患者的受照剂量。结果X射线透视下食管支架置入术时,高、中、低3个剂量组患者的有效剂量分别为10.773、4.004、1.889 mSv。高、中、低3个剂量组中不同组织或器官吸收剂量值最大的为红骨髓,其次为肌肉、食管、肺等,最小值为睾丸。结论患者有效剂量的估算结果与实验条件中透视时间的长短、累积剂量和DAP的大小成正比;不同剂量组中,同一组织、器官吸收剂量的大小随透视时间的增加而增大;同一剂量组中,不同组织、器官吸收剂量的大小与组织权重因子、质量能量吸收系数的大小及该组织、器官是否受到主射束照射等因素密切相关。Objective To estimate patient’s exposure dose during esophageal stent placement under X-ray fluoroscopy through anthropomorphic phantom experiments. Methods Investigated 60 cases of esophageal stent implantation provincial tertiary hospitals and recorded intraoperative fluoroscopy time, tube voltage, tube current and other information. The anthropomorphic phantom experiments were divided into 3 groups according to the duration of fluoroscopy, cumulative dose and the size of the DAP, and a pyroelectric dosimeter was placed in predetermined holes within the anthropomorphic phantom to restore the surgical procedure in groups according to the experimental conditions. The patient’s dose was estimated based on the results of the thermoluminescence dosimeter. Results In this study, under X-ray fluoroscopic esophageal stent placement, the effective doses for patients in the high, medium, and low dose groups were 10.773, 4.004 and1.889 mSv, respectively. The highest values of absorbed dose from different tissues or organs in the three dose groups(high,medium and low) were in the red bone marrow, followed by muscle, esophagus and lung, with the lowest values in the testes.Conclusion Estimates of the effective dose to patients were proportional to the duration of fluoroscopy, cumulative dose,and size of DAP in the experimental conditions. The magnitude of the absorbed dose to the same tissue and organ increases with increasing fluoroscopy time in different dose groups. The amount of absorbed dose to different tissues and organs in the same dose group is closely related to the tissue weighting factor, the magnitude of the mass-energy absorption coefficient and whether the tissue or organ is irradiated by the main beam.

关 键 词：食管支架置入术 仿真人体模型 患者 剂量 

分 类 号：R144.1[医药卫生—公共卫生与预防医学]