甲状腺癌患者^(131)I治疗过程中的外照射剂量水平分析  

Analysis of external exposure dose during^(131)I treatment for thyroid cancer patient

作　　者：张庆召[1] 李文亮[2] 朱卫国[1] 梁婧[1] 练德幸[1] 侯长松[1] Zhang Qingzhao;Li Wenliang;Zhu Weiguo;Liang Jing;Lian Dexing;Hou Changsong

机构地区：[1]中国疾病预防控制中心辐射防护与核安全医学所辐射防护与核应急中国疾病预防控制中心重点实验室,北京100088 [2]河南省肿瘤医院核医学科,郑州450000

出　　处：《中华放射医学与防护杂志》2021年第5期353-357,共5页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的通过测量甲状腺癌患者^(131)I治疗过程中患者周围剂量当量率及住院期间胸前体表的累积剂量,探讨加强^(131)I治疗过程中辐射防护问题。方法在某开展甲状腺癌患者^(131)I治疗的医院,选取接受^(131)I治疗的患者78名,用γ辐射巡测仪测量患者服用^(131)I药物后10 min、1、2、5 d共5个时间点的周围剂量当量率;测量距离分别为体表5、0.5和1 m处;测量方向为患者前后左右4个方向。用光激发光剂量计测量患者胸前位置住院期间(6 d)接受的累积吸收剂量。结果服药后10 min患者胸前体表5 cm处周围剂量当量率最高可达4.81 mSv/h,患者出院前胸前体表5 cm处周围剂量当量率范围在2.6~64.1μSv/h,住院期间患者胸前体表的累积剂量在15.9~58.8 mGy之间。服药10 min后3.7 GBq药剂量组与5.55 GBq药剂量组患者体表5 cm处剂量率差异有统计学意义(t=-6.11,P<0.05),服药10 min后男性与女性患者体表5 cm处剂量率差异有统计学意义(t=4.52,P<0.05),其他组别差异无统计学意义(P>0.05)。结论在甲状腺癌患者^(131)I治疗过程中,患者周围具有较高的辐射水平,应加强对患者的防护及管理,减少周围公众不必要的照射。Objective To explore the existing issues in radiation protection during the treatment of^(131)I by means of measuring the ambient dose equivalent rate to patients with thyroid cancer and the dose equivalent to the surface of chest of patients during hospitalization.Methods The ambient dose equivalent rate(peer)was measured by using gamma ray detector for selected 78 patients who received^(131)I treatment in a hospital 10 min,1 d,2 d,3 d and 5 d after administration with^(131)I.The measurements were made at distances of 5 cm,0.5 m and 1 m from the body surface in front,rear,left and right directions.The photoluminescence dosimeter on the chest of the patients was used to measure the effective dose during hospitalization period(6 d).Results The ambient dose equivalent rate on the surface of chest of patients was up to 4.81 mSv/h 10 min after administration of medicine.The dose equivalent on the surface of chest of patients before discharge ranged 2.6-64.1μSv/h.The cumulative dose on chest surface during hospitalization was 15.9-58.8 mGy.There was a significant difference in the dose rate at 5 cm from the body surface between 3.7 GBq group and 5.55 GBq group 10 min after medication(t=-6.11,P<0.05).There was a significant difference in the dose rate at 5 cm from the body surface between male and female groups 10 min after medication(t=4.52,P<0.05).There was no significant difference in other groups(P>0.05).Conclusions During the^(131)I treatment,patients had high level of radiation around them,so it is necessary to strengthen the protection and management of patients and reduce unnecessary exposure to the public.

关 键 词：甲状腺癌 ^(131)I治疗 周围剂量当量率 

分 类 号：R736.1[医药卫生—肿瘤] R730.55[医药卫生—临床医学]