心血管介入诊治中的放射防护状况调查

Investigation of radiation exposure protection of cardiovascular intervention

目的了解心血管造影机放射线在心脏介入术中对不同人员、不同部位的影响,并对防护设施的防护效果进行调查,探讨其中的规律,旨在为防止过度辐射提供客观依据。方法共对12台普通冠状动脉造影和25台经皮冠状动脉介入治疗(PCI)手术的放射线剂量进行了测定。X线测定计量元件放置在医、患及机器设备的不同位置,研究对象分为两组:第一组包括术者、助手和巡回护士,分别摆放6个位置,共计18个点;第二组为患者及铅屏的不同部位,共10个点。计量元件由放射卫生防护所的专门技术人员进行测量。结果随着透视、曝光的时间延长,透视剂量、曝光剂量上升。在28个监测点上,辐射剂量有明显的不同。术者的左前上臂及患者的左腋下及后背部所受放射量最大。铅屏和铅衣可阻挡90%以上的放射线。结论应用大型血管造影机行心脏介入检查和治疗,目前的X线防护措施是有效的。但术者某些部位的受照剂量仍高,应引起足够的重视。

Objective To investigate the radiation doses in different areas around the operation table during intervention procedure and to study the effect of X-ray protection equipments. Methods A total of 37 procedures （12 diagnostic cardiac angiographies and 25 percutaneous coronary intervention therapy） were investigated. The detection of X-ray was carried out in 2 separate groups. The first group included the operators, assistants and nurses. There were 6 detecting points on each person resulting in a total of 18 detecting points. The second group consisted of 10 detecting points on different areas of the patients and the protecting lead shields around. The measurement of X-ray doses was performed by the specialist from the radiation protection agency. Results The doses of X-ray was directly proportional to the duration of exposure. The X-ray doses varied among the 28 detecting points. The highest amount of radiation were detected on the left ann of the operator and on the left axilla and the back of the patients. Above 90% of radiation could be protected by lead shields and lead clothes. Conclusion Lead protective products available at precent are efficient in protecting radiation exposure during cardiovascular intervention procedures. More attention still need to be paid to certain highly exposed areas.