子宫输卵管造影中受检者不同体型及不同体位的曝光条件的差异及降低剂量的方法研究

Study on the difference of exposure conditions and the method of reducing the dosage of the different types of patients and the different positions in the patients with fallopian tube radiography

目的了解子宫输卵管造影中受检者不同体型及不同体位的曝光条件的差异,探讨降低照射剂量的方法。方法选择159例疑诊为不孕症的受检者为对象,根据其皮下脂肪的厚度分为消瘦组42例、正常组79例、肥胖组38例三组。同期疑诊为不孕症的女性受检者中再随机抽取129例,分为A组75例和B组54例。A组采用自动曝光条件,B组采用手动调节曝光。分别记录各组曝光参数(KV,m As),造影检查过程中发现有输卵管梗阻现象时嘱患者分别向左或向右抬高臀部45°后再次造影,并记录体位变换前后的曝光参数。结果各组的曝光条件(KV、m As)差异有显著性,以消瘦组的曝光条件最低,正常组次之,肥胖组的曝光条件最高;变换体位前后的曝光条件,平卧位KV值低于倾斜45°,差异具有显著性;m As变换体位前后无显著差异;手动调节的曝光方式较自动调节的曝光方式的曝光条件明显降低。结论在子宫输卵管造影过程中,根据受检者不同的体型,采用手动调节的曝光方式,选择合适的曝光参数,能有效降低受检者的照射剂量。

Objective To investigate the differences of exposure factors in various kinds body types patients in hysterosalpingography,ex-plore the methods to reduce the exposure dose. Methods 159 doubtful Infertile patients from reproductive center in our hospital were divided into 3 groups：leptystic,normal and fat,according to the thick of subcutaneous fat,and register the exposure factors,if proximal tubule ＂obstructions＂during hysterosalpingography were observed,and then the patients were rotated approximately 45？to left or right oblique position and the procedure was continued and register the exposure factors. Then 129 women were randomly selected from reproductive center in our hospital and divided into 2 groups again：group A（automatically exposure）and group B（manually exposure）. The exposure parameter was recorded and the density of the site at the vaginal speculum were measured. Results The differences of exposure factors in the 3 groups are evident（ P 〈 0. 01）,the exposure factors of fat group was maximum,followed by normal,leptystic group. Exposure conditions before and after changing position,supine inclined KV values below 45＆#176;,the difference was significant;no significant difference was observed between before and after changing position mAs. Exposure conditions of exposure mode with manually adjusting was reduced than that of automatically adjusting method. Conclusion According to various body types,employing manually exposure,choosing proper exposure factors,the methods which can effectively reduce radiation dose of patient,and ensure the image quality well.