C型臂X线机对骨科创伤手术患者术中非手术部位的辐射研究  

Study on the radiation of C-arm X-ray machine to the non-surgical sites of patients undergoing orthopedic surgery

作　　者：周小花 殷国勇[2] 于婷婷 王成跃[3] 石磊 韦金翠 ZHOU Xiaohua;YIN Guoyong;YU Tingting;WANG Chengyue;SHI Lei;WEI Jincui(Department of Anesthesia and Perioperative Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,210029;Department of Orthopedics,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,210029;Department of Clinical Engineering,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,210029)

机构地区：[1]南京医科大学第一附属医院麻醉及围术期医学科,江苏南京210029 [2]南京医科大学第一附属医院骨科,江苏南京210029 [3]南京医科大学第一附属医院临床工程处,江苏南京210029

出　　处：《实用临床医药杂志》2022年第24期121-124,148,共5页Journal of Clinical Medicine in Practice

基　　金：国家自然科学基金项目(82030069)。

摘　　要：目的探讨C型臂X线机(简称C臂机)对骨科创伤手术患者术中非手术部位的辐射剂量及辐射防护策略。方法选取行全身麻醉骨科手术治疗的456例患者作为研究对象,按是否采用铅毯防护分为防护组和未防护组,术中均使用同一品牌C臂机进行定位及诊断。未防护组患者术中未使用铅毯防护,比较该组患者非手术部位辐射剂量的差异,并分析照射次数对非手术部位辐射剂量的影响;防护组患者术中使用铅毯对非手术部位进行防护,比较2组非手术部位辐射剂量的差异。结果未防护组中,同一手术部位患者的不同非手术部位的辐射剂量比较,差异均有统计学意义(P<0.05),其中肱骨手术辐射剂量最高的非手术部位为胸腰部,股骨手术、胫腓骨手术则为会阴部;未防护组不同部位手术中,照射次数≥4次患者的重点防护部位辐射剂量均高于照射次数<4次患者,差异有统计学意义(P<0.05)。防护组肱骨手术胸腰部、股骨手术会阴部、胫腓骨手术会阴部的辐射剂量依次为(87.94±20.44)、(111.69±19.03)、(71.13±21.09)μGy/h,分别低于未防护组的(426.65±92.49)、(448.78±85.20)、(370.56±62.15)μGy/h,差异有统计学意义(P<0.05)。结论距离手术部位越近,术中C臂机照射次数越多,则骨科创伤手术患者非手术部位接受的辐射剂量越高,而采用铅毯防护可有效降低非手术部位的辐射剂量。医护人员应采取相应防护措施保护手术患者距离手术部位较近的重要器官,从而避免放射性损害。Objective To investigate the radiation dose and radiation protection strategy of C-arm X-ray machine(C-arm machine for short)on non-surgical sites of orthopedic trauma patients.Methods A total of 456 patients who underwent orthopedic surgery under general anesthesia were selected as research objects and divided into protected group and unprotected group according to whether lead blanket was used or not.The same brand C-arm machine was used for positioning and diagnosis during the operation.In the unprotected group,lead blanket was not used during the operation,the difference of radiation dose in the non-surgical site was compared,and the influence of irradiation times on the radiation dose in the non-surgical site was analyzed.Lead blankets were used to protect the non-surgical sites in the protective group during the operation,and the difference of radiation dose in the non-surgical sites was compared between the two groups.Results In the unprotected group,there were statistically significant differences in the radiation dose of different non-surgical sites in patients with the same surgical site(P<0.05).The highest radiation dose of humeral surgery was in the thorax and waist,while that of femur and tibia and fibula surgery was in the perineum.In the unprotected group with different sites of surgery,the radiation dose of the key protected site in patients with≥4 times of exposures was more than that of patients with<4 times of exposures(P<0.05).In the protection group,the radiation dose in the perineum of humerus operation,femur operation and tibia and fibula operation were(87.94±20.44),(111.69±19.03),(71.13±21.09)μGy/h,respectively,which were lower than(426.65±92.49),(448.78±85.20)and(370.56±62.15)μGy/h,respectively in the unprotected group(P<0.05).Conclusion The closer the distance to the surgical site and the more intraoperative C-arm irradiation times is,the higher the radiation dose received by the patients in the non-surgical site of orthopedic trauma surgery will be.The use of lead blanket prot

关 键 词：C型臂X线机 骨科创伤手术 非手术部位 辐射剂量 铅毯 防护策略 

分 类 号：R473.6[医药卫生—护理学] R816.8[医药卫生—临床医学]