心血管介入术中医务人员眼晶状体剂量水平调查与分析  

A study and analysis of eye lens dose levels of medical staff during interventional cardiology procedures

作　　者：齐素芹 刘翎箭 郭进[2] 孙训[3] 潘志伟 刘安生 QI Suqin;LIU Lingjian;GUO Jin;SUN Xun;PAN Zhiwei;LIU Ansheng(Wuhan Prevention and Treatment Center for Occupational Diseases,Wuhan 430015 China;Wuhan Asia Heart Hospital,Wuhan 430022 China;Shanghai Institute of Metrology and Testing Technology,Shanghai 201203 China)

机构地区：[1]武汉市职业病防治院,湖北武汉430015 [2]武汉亚洲心脏病医院,湖北武汉430022 [3]上海市计量测试技术研究院,上海201203

出　　处：《中国辐射卫生》2023年第5期532-537,共6页Chinese Journal of Radiological Health

基　　金：武汉市卫生健康科研基金资助(WG19Y04)。

摘　　要：目的分析心血管介入术中医生眼晶状体当量剂量水平及相关影响因素。方法选取某心血管专科医院20名介入医生,监测手术期间的眼晶状体累积当量剂量,记录设备相关参数[透视时间、剂量面积乘积(DAP值)、患者入射体表剂量(ESD值)]及手术类型、术者位等。结果7名医生眼晶状体年当量剂量平均水平超过20 mSv,周手术量与眼晶状体周当量剂量存在线性相关(R^(2)=0.457,P=0.001)。单例手术眼晶状体当量剂量平均水平M为17.1μSv,透视时间、DAP值及ESD值与眼晶状体当量剂量均存在线性相关(R^(2)=0.427、0.206、0.237,P<0.05)。开展经皮穿刺冠状动脉支架植入(CA+PCI)的透视时间、DAP值、ESD值和眼晶状体当量剂量均高于冠状动脉造影术(CA),(t=-3.226、-3.108、-3.061、-2.667,P<0.03)。结论介入放射学工作人员眼晶状体年当量剂量较高,部分人员可能超过ICRP规定的最新剂量限值(20 mSv)。应重点关注开展冠状动脉支架植入术的工作人员,实际操作中应优化工作负荷、减少不必要的透视时间,降低工作人员眼晶状体受照剂量。Objective To analyze the eye lens equivalent dose levels of doctors during interventional cardiology procedures and identify related influential factors.Methods Twenty interventional specialists were selected from a cardiovascular specialty hospital.The cumulative equivalent doses to their eye lens during operations were monitored,and equipment-related parameters(fluoroscopy time,dose area product value[DAP],and entrance skin dose[ESD]),operation types,and operators’positions were recorded.Results The annual equivalent doses to the eye lens of seven doctors exceeded 20 mSv.There was a linear correlation between the weekly number of operations and the equivalent dose to the eye lens(R^(2)=0.457,P=0.001).The mean eye lens equivalent dose per operation was 17.1μSv,showing linear correlations with fluoroscopy time,DAP values,and ESD values(R^(2)=0.427,0.206,and 0.237,respectively,P<0.05).The fluoroscopy time,DAP value,ESD value,and eye lens equivalent dose during percutaneous coronary intervention(PCI)were significantly higher than those during coronary angiography(t=-3.226,-3.108,-3.061,and-2.667,respectively,P<0.03).Conclusion The annual equivalent doses to the eye lens are relatively high in interventional radiologists,some of whom may have values higher than the latest dose limit(20 mSv)suggested by the International Commission on Radiological Protection.Attention should be paid to operators performing PCI,and the workload optimization is necessary in practical operations to avoid unnecessary fluoroscopy time and reduce the eye lens doses of the operators.

关 键 词：心血管介入 放射工作人员 眼晶状体剂量 

分 类 号：X591[环境科学与工程—环境工程]