基于真实世界数据放射介入医生辐射受照剂量研究  

Study on radiation dose received by interventional radiologists based on real-world data

作　　者：柏彭开 冯喜明 储晓阳[1,2] 招晓俊[1] 朱波[1] 胡强[1] Bai Pengkai;Feng Ximing;Chu Xiaoyang;Zhao Xiaojun;Zhu Bo;Hu Qiang(Department of Medical Equipment,The Second Affiliated Hospital of Guangxi Medical University,Naning 530000,China;Department of Clinical Engineering,Guangxi Medical University,Naning 530000,China)

机构地区：[1]广西医科大学第二附属医院医疗设备科,南宁530000 [2]广西医科大学临床工程教研室,南宁530000

出　　处：《现代仪器与医疗》2023年第5期27-35,共9页Modern Instruments & Medical Treatment

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190365)。

摘　　要：目的对医院放射介入手术医生手部受电离辐射照射计量进行采集,估算皮肤吸收剂量,为放射介入防护提供参考。方法包括介入手术辐射特征分析和医生手部受照剂量采集与计算两阶段。运用真实世界研究方法,首先对广西某三甲医院经皮冠状动脉介入术(Percutaneous Coronary Intervention,PCI)和全脑血管造影术曝光时间及机器产生射线剂量进行普查,分析两种手术曝光时间和射线剂量分布情况;其次使用指环式热释光剂量计监测该院手术医生手部受照剂量,根据《电离辐射所致皮肤剂量估算方法》估算皮肤吸收剂量。使用SPSS 25.0进行统计学分析,计量资料采用独立样本t检验、四分位数M(P_(25)~P_(75))、平均值标准差等分析描述,数据分布采用直方图和箱式图表达。结果介入术辐射特征分析收到PCI术641例,全脑血管造影术328例,两种手术曝光时间和机器射线剂量用四分位数表达,分别是PCI术680(430,1090)s、560(248,1108.5)mGy;全脑血管造影术600.5(442.5,855.3)s、481.5(363.3,666.5)mGy。医生手部受照剂量采集到PCI术20例,全脑血管造影术10例,其中PCI术医生手皮肤HP(0.07)当量剂量0.07(0.05,0.10)mSv、医生手皮肤HP(0.07)吸收剂量0.04(0.03,0.06)mGy,全脑血管造影术医生手皮肤HP(0.07)当量剂量0.085(0.07,0.11)mSv、医生手皮肤HP(0.07)吸收剂量0.05(0.04,0.06)mGy。结论两种手术曝光时间、射线剂量、皮肤受照剂量当量、吸收剂量等体现出高度离散分布特征,当PCI术超2166台/年或全脑血管造影术超3503台/年时,医生手部受照剂量有超国家限值风险。Objective This study aims to collect data on the ionizing radiation exposure dose to the hands of interventional surgeons in hospitals,estimate the skin absorbed dose,and provide reference for radiation protection in interventional procedure.Methods The methodology includes a two-stage intervention:analysis of radiation characteristics during surgical procedures and collection and calculation of radiation doses on doctors’hands.By utilizing a real-world research approach,a survey was conducted on the exposure time and radiation doses generated by the machines during percutaneous coronary intervention(PCI)and cerebral angiography procedures in a tertiary hospital in Guangxi.The distribution of exposure time and radiation doses for both procedures was analyzed.Subsequently,a ring-type thermoluminescent dosimeter was used to monitor the radiation doses received on the hands of the surgical doctors.Skin absorption doses were estimated based on the“Estimation Method for Skin Doses Caused by Ionizing Radiation”.Statistical analysis was performed using SPSS 25,with dose data analyzed using independent samples t-test,quartiles M(P_(25)~P_(75)),mean,and standard deviation.The data distribution was visualized using histograms and boxplots.Results The survey included 641 cases of PCI and 328 cases of cerebral angiography.The exposure time and radiation dose for these two procedures were expressed as quartiles:for PCI,the exposure time was 680(430,1090)seconds,and the radiation dose was 560(248,1108.5)mGy.For cerebral angiography,the exposure time was 600.5(442.5,855.3)seconds,and the radiation dose was 481.5(363.3,666.5)mGy.The radiation dose to the hands of surgeons was collected from 20 cases of PCI and 10 cases of cerebral angiography.For PCI,the equivalent dose to the skin of the hands[HP(0.07)]was 0.07(0.05,0.10)mSv,and the absorbed dose to the skin of the hands[HP(0.07)]was 0.04(0.03,0.06)mGy.For cerebral angiography,the equivalent dose to the skin of the hands[HP(0.07)]was 0.085(0.07,0.11)mSv,and the absorbed d

关 键 词：放射介入手术 X射线 剂量当量 吸收剂量估算 辐射防护 

分 类 号：TH774[机械工程—仪器科学与技术] R144.1[机械工程—精密仪器及机械]