90Y树脂微球治疗在临床应用中的放射防护研究  

Radiation protection in clinical application of yttrium⁃90⁃loaded resin microsphere therapy

作　　者：冯加武 孙敬智 王韶佳 张力 周旋 凌瑞杰 Feng Jiawu;Sun Jingzhi;Wang Shaojia;Zhang Li;Zhou Xuan;Ling Ruijie(Occupational Health Department,Hubei Provincial Hospital of Integrated Chinese and Western Medicine(Hubei Provincial Hospital for Occupational Disease),Wuhan 430015,China)

机构地区：[1]湖北省中西医结合医院(湖北省职业病医院)职业卫生科,武汉430015

出　　处：《中华放射医学与防护杂志》2024年第1期36-40,共5页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的探讨90Y树脂微球治疗在临床应用中的放射防护措施。方法模拟90Y树脂微球治疗手术流程,通过监测术前药物分装准备、药物转运、术中药物操作和输注、术后患者住院观察各个阶段周围剂量当量率水平,分析临床应用中所应采取的放射防护措施。结果活性室周围剂量当量率水平为0.12~0.42μSv/h,通风橱周围剂量当量率为1.04~3.32μSv/h。数字减影血管造影(DSA)室在90Y+DSA扫描时最高为0.78μSv/h,在99 Tc^(m)+DSA时最高为036μSv/h;透视防护区在90Y药物时在第一术者位155 cm高度为13.19μSv/h,而在90Y+DSA扫描时最高为80 cm高度处315.01μSv/h。第二术者位在90Y药物时最高为155 cm高度为628μSv/h,90Y+DSA扫描时最高为155 cm高度处291.03μSv/h。患者病房周围剂量当量率为0.11~0.58μSv/h。结论核医学科及介入室等原有屏蔽措施能够满足90Y树脂微球治疗的放射防护要求,但仍需根据实际情况进行科学评估,同时应加强药物操作中的放射防护及表面污染处理措施。Objective To explore the radiological protection measures for yttrium⁃90(90Y)⁃loaded resin microsphere therapy in clinical application.Methods The surgical operation process for 90Y⁃loaded resin microsphere therapy was simulated,involving measurement of ambient dose equivalent rates at various stages:preoperative preparation(dominated by drug package),drug transfer,intraoperative procedures(drug operation and injection),and postoperative care and observation within the hospital.Based on the simulation,the protection measures in clinical application were analyzed.Results The dose equivalent rate ranged from 0.12 to 0.42μSv/h around the active chamber and from 1.04 to 3.32μSv/h in the fume hood.Around the digital subtraction angiography(DSA)room,the maximum dose equivalent rate was 078μSv/h when 90Y and DSA were applied simultaneously and 0.36μSv/h when 99 Tc m and DSA were applied.For the first operating position in the fluoroscopy protection area,the maximum dose equivalent rate was 13.19μSv/h at 155 cm height when only 90Y was applied,and 315.01μSv/h at 80 cm height when 90Y and DSA were applied.For the second operating position,the maximum dose equivalent rate was 6.28μSv/h at 155 cm height when only 90Y was applied and 291.03μSv/h at the same height when 90Y and DSA were applied.The dose⁃equivalent rates ranged from 0,11 to 0.58μSv/h around the dedicated ward for postoperative patients.Conclusions The existing shielding measures,such as those in the nuclear medicine department and interventional room,meet the radiation protection requirements for 90Y⁃loaded resin microsphere therapy.However,it is still necessary to conduct a scientific assessment based on the actual situation.Additionally,radiation protection measures and surface contamination treatment should be enhanced during drug operation.

关 键 词：90Y树脂微球 放射防护 周围剂量当量率 

分 类 号：R818[医药卫生—放射医学]