心血管介入诊疗患者峰值皮肤剂量水平测量与分析  

Measurement and analysis of peak skin dose for patients with interventional cardiology procedures

作　　者：赵俏俏 范瑶华[1] 黄卓[1] 徐辉[1] 欧向明[1] ZHAO Qiaoqiao;FAN Yaohua;HUANG Zhuo;XU Hui;OU Xiangming(Key Laboratory of Radiological Protection and Nuclear Emergency,China CDC,National Institute for Radiological Protection,Chinese Center for Disease Control and Prevention,Beijing 100088 China)

机构地区：[1]中国疾病预防控制中心辐射防护与核安全医学所、辐射防护与核应急中国疾病预防控制中心重点实验室,北京100088

出　　处：《中国辐射卫生》2024年第3期229-233,共5页Chinese Journal of Radiological Health

摘　　要：目的获得心血管介入诊疗患者峰值皮肤剂量(PSD)数据,评估患者确定性效应发生风险。方法使用Gafchromic XR RV3胶片剂量计采集北京市某三级甲等医院进行心血管介入诊疗患者的峰值皮肤剂量,主要研究冠状动脉造影术、经皮冠状动脉腔内血管成形术、射频消融术、先天性心脏病介入治疗等常见的手术类型。使用EPSON EXPRESSION 10000XL扫描仪扫描胶片,FILM QA Pro;TM;2014软件测量和分析胶片。结果共采集59例心血管介入诊疗患者的峰值皮肤剂量数据,包括冠状动脉造影术23例、经皮冠状动脉腔内血管成形术21例、射频消融术9例、先天性心脏病介入治疗6例。PSD≥2 Gy患者7例,均为经皮冠状动脉腔内血管成形术,其中1例PSD超过3 Gy,其余均小于2 Gy。结论部分心血管介入诊疗患者的PSD超过国际放射防护委员会第118号报告中的确定性效应剂量阈值,提示心血管介入诊疗存在确定性效应发生风险,其中经皮冠状动脉腔内血管成形术患者风险较高。Objective To obtain the peak skin dose(PSD)of patients with interventional cardiology procedures and to evaluate the risk of deterministic effects.Methods Gafchromic XR RV3 films were used in a Level A tertiary hospital in Beijing to measure the PSD of patients who underwent interventional cardiology procedures.The measurement focused on four common types of procedures,including coronary angiography,percutaneous transluminal coronary angioplasty,catheter radiofrequency ablation,and congenital heart disease.The films were scanned by EPSON EXPRESSION 10000XL and analyzed by FILM QA ProTM 2014 software.Results PSD was measured in 59 patients with interventional cardiology procedures,including 23 with coronary angiography,21 with percutaneous transluminal coronary angioplasty,9 with catheter radiofrequency ablation,and 6 with congenital heart disease.The seven patients with PSD≥2 Gy all underwent percutaneous transluminal coronary angioplasty,one with PSD>3 Gy and six with PSD<2 Gy.Conclusion The PSD of some patients with interventional cardiology surgery exceeded the dose threshold of deterministic effects recommended by the ICRP 118.There is a risk of deterministic effects in interventional cardiology surgery,especially in patients with percutaneous transluminal coronary angioplasty.

关 键 词：心血管介入手术 峰值皮肤剂量 剂量阈值 确定性效应 

分 类 号：X591[环境科学与工程—环境工程]