C型臂X线机在小儿骨科应用中的放射防护

Radiation protection for the C-arm X-ray machine in orthopedic operation of children

目的:加强C型臂X线机术中应用的放射防护措施,保障骨科手术患儿及医务人员的健康。方法:采用辐射剂量检测仪,现场检测C型臂X线机应用时床边手术人员和骨科手术患儿的受照剂量率,评价其放射防护情况及防护措施的有效性。结果:距离C型臂X线机越近,受照剂量越突出,距离越远,受照剂量相对较少,且其他部位均有防护措施,手部无任何防护措施。术中管球位于手术床上下各50 cm时,不同术式患者的受照剂量率平均值不同,胫腓骨骨折固定术时,足部受照剂量最显著,股骨颈骨折固定术及股骨干(粗隆间)骨折复位术时,会阴部受照剂量最显著,腰椎滑脱固定术时,会阴部受照剂量最显著,手外伤固定术时,手部的受照剂量最显著。结论:C型臂X线机术中应用时存在放射防护问题,采用个性化防护、屏蔽防护、时间防护及距离防护、医患共同防护等综合防护措施,可降低医务人员及骨科手术患儿的受照剂量,最大限度地减少电离辐射对医务人员和骨科手术患儿健康的影响。

Objective:To strengthen application of radiation protection measures of the C-arm X-ray machine in operations,and protect patients and medical staff’s health in orthopedic surgery.Methods:We used radiation dose detector to test the intraoperative radiation dose rates of surgical staff and children in orthopedic surgery and evaluate the protection conditions and its effectiveness of protective measures.Results:The more close of distance to C-arm X-ray machine was,the more notable of radiation dose was.And the farer the less.Other positions had protection measures except the hands.The mean radiation dose rates were different in different operations when the X-ray tube was 50 cm above or down the operation bed.The radiation dose of food was most notable in fixed operation of shin and fibula fractures.The radiation dose of pudendum was most notable in fixed operation of thigh neck and stem fractures.The radiation dose of pudendum was most notable in fixed operation of lumbar vertebra drop.The radiation dose of hands was most notable in fixed operation of hand injury.Conclusion:There were radiation protection problems of C-arm X-ray machine in operations.We must strengthen the comprehensive protection measures including individual protection,shielding protection,time protection,distance protection,doctor and patient co-protection to reduce the radiation doses of medical staff and children in orthopedic surgery and minimize radiation effect on medical staff and children in orthopedic surgery.