冠状动脉介入术者下肢射线剂量的影响因素及防护  

Influencing factors of radiation dose and radiation protection of the operator's lower limb in coronary interventional procedures

作　　者：钱海[1] 胡德兴 岑泽民[1] 楼钶楠[1] 章璐幸[2] QIAN Hai;HU Dexing;CEN Zemin;LOU Kenan;ZHANG Luxing(Department of Cardiology,Ningbo Medical Center LihuiLi Hospital,Ningbo,Zhejiang Province 315040,China;Instrumental Analysis Center,Zhejiang Pharmaceutical College,Ningbo,Zhejiang Province 315100,China)

机构地区：[1]宁波市医疗中心李惠利医院心血管内科,浙江宁波315040 [2]浙江医药高等专科学校仪器分析中心,浙江宁波315100

出　　处：《实用放射学杂志》2021年第12期2069-2072,共4页Journal of Practical Radiology

摘　　要：目的探讨冠状动脉介入术者下肢暴露部位射线剂量与部位高度、术者位置、造影体位及射线防护强度之间的关系。方法用仿真人体模型代替患者进行曝光,桡动脉途径下采集2位模拟术者左足、左小腿在不同防护下的体表入射剂量率。采用独立样本t检验对无防护时左足和左小腿间及2位模拟术者间的体表入射剂量率进行比较;采用单因素方差分析对无防护时各体位间的体表入射剂量率以及不同防护条件间的体表入射剂量率进行比较;计算不同防护下的射线屏蔽率。结果无防护时,2位模拟术者下肢的体表入射剂量率均较高,左小腿的体表入射剂量率高于左足(P<0.05),第1术者下肢在多数体位的体表入射剂量率高于第2术者(P<0.05)。防护越强,下肢体表入射剂量率越低(P<0.05)。单纯床旁防护时在多数体位,左小腿的射线屏蔽率高于左足,第2术者下肢的射线屏蔽率高于第1术者。床旁防护配合射线防护靴时,射线屏蔽率较单纯床旁防护明显升高。结论冠状动脉介入术者下肢暴露部位的射线剂量受部位高度、术者位置、造影体位及防护强度等多种因素综合影响,单纯床旁防护对小腿和第2术者下肢的防护效果更好,射线防护靴弥补了单纯床旁防护的不足。Objective To discuss the relationship between limb height,standing position,C-arm angulation,physical protection intensity and radiation dose of the operator's lower limb in coronary interventional procedures.Methods An anthropomorphic phantom was analog of a real patient.In trans-radial approach,the entrance surface dose rates of the simulated operator's left foot and left shank were measured under different radiation protection conditions.Independent sample t test was used to determine statistical differences of the entrance surface dose rates between left foot and left shank.Independent sample t-test was also used to determine statistical differences of the entrance surface dose rates between two operators without protection.A NOVA was used to determine statistical differences of the entrance surface dose rates among different C-arm angulations without protection.A NOVA was also used to determine statistical differences of the entrance surface dose rates among different protection conditions.The X-ray shielding ratios under different protection conditions were calculated.Results The entrance surface dose rates of the operator's lower limb were high without protection.Without protection,the entrance surface dose rates of left shank were higher than those of left foot(P<0.05),and the entrance surface dose rates of the first operator's lower limb were higher than those of the second operator at most C-arm angulations(P<0.05).The more radiation protection was,the lower the entrance surface dose rate was(P<0.05).With simple bedside protection,at most C-arm angulations,the X-ray shielding ratios of left shank were higher than those of left foot,and the X-ray shielding ratios of the second operator's lower limb were higher than those of the first operator.With bedside protection and X-ray protective boots,the X-ray shielding ratios were significantly higher than those with simple bedside protection.Conclusion In trans-radial coronary interventional procedures,the radiation dose of the operator's lower limb is compreh

关 键 词：冠状动脉介入 下肢 体表入射剂量率 射线防护 

分 类 号：R815[医药卫生—放射医学] R68[医药卫生—临床医学]