放射安全防护干预措施在社区医疗放射中的效果评估

Effect of intervention and radiological protection on radiological level in community hospital

目的探讨放射安全防护干预措施在社区医疗放射辐射中的效果。方法对广州市海珠区沙园街社区卫生服务中心各类医用射线机,如高频数字胃肠机、高频拍片机、CR、牙科机、碎石机等,工作场所,职业人群,就诊患者及我中心附近本社区公众群众,根据辐射防护的三个基本原则及防护标准要求进行防护干预、监督及监测。采用BH3103X-γ射线便携式巡测仪进行射线防护监测,FJ-377热释光剂量仪进行个人剂量监测,LiF(Mg,Cu,P)热释光剂量计、S-95多道γ谱仪进行空气放射性污染监测等进行实时监控。通过计算机软件管理,输入整理出相应数据,检测干预前后辐射水平空气比释动能率及放射个人剂量变化,进行统计分析。结果防护干预前后比较,候诊室位、诊治室外走廊、诊室内辐射水平空气比释动能率明显下降(P<0.05);外墙壁、通风窗及公共场所(P<0.01)、工作人员位(P<0.05)结果均低于GB18871-2002《电离辐射防护与辐射源安全基本标准》中的剂量限值20 mSv/a的导出值10μGy/h。干预前后个人剂量监测结果比较:工作人员由干预前(5.08±1.96)mSv/a下降至(4.21±1.89)mSv/a,差异有统计学意义(P<0.05);就诊患者由(3.29±1.35)mSv/a降至(2.77±0.93)mSv/a(P<0.01);社区公众由(2.11±0.86)mSv/a降至(1.18±0.76)mSv/a(P<0.01)。结论放射安全防护干预措施可以改善社区医疗放射辐射预防效果,减轻辐射水平,有利于职业人群、就诊患者及我中心附近本社区公众群众的身心健康。

Objective To evaluate the effect of intervention and radiological protection on radiological level in community hospital. Methods The radiological Air kerma rate of CR, DR and such as medical instruments, and the dosage of the individual exposure level of radiological workers, patients and normal people in the Community Health Service Center of Shayuan Street in Haizhu District in Guangzhou City were measured between before and after intervention with thermoluminescent method. BH3103X-γ ray portable survey instrument was used to detect the radiation protection, FJ-377 thermoluminescent dosimeter was taken to detect the individual dose, LiF （Mg, Cu, P） thermolumineseent dosemeter, S-95 multichannel gamma spectrometer were used to take real time monitoring for airborne contamination. Through computer software management, corresponding data was input and settled. The radiological air kerma rate and changes of personal radiation doses before and after the intervention were detected and analyzed statistically. Results The radiologieal air kerma rate of waiting room, corridor out of consulting room and in the consulting room was decreased before and after intervention （P 〈 0.05）. The level of the wall outside, ventlight and public place （P 〈 0.01）, workers （/9 〈 0.05） were all significantly lower than the export value 10 μGy/h of limit dosage 20 mSv/a by GB18871- 2002 Basic standard of ionizing radiation protection and radiation sources safety. Compared with the results of personal dosage monitor before and after intervention： the workers decreased from （5.08±1.96） mSv/a before the intervention to （4.21±1.89） mSv/a after the intervention, with a significant difference （P 〈 0.05）; hospitalized patients decreased from （3.29±1.35） mSv/a before the intervention to （2.77±0.93） mSv/a after the intervention （P 〈 0.01）; the community public decreased from （2.11 ±0.86） mSv/a before the intervention to （1.18±0.76） mSv/a after the intervention （P 〈 0.01）. Conclusion Intervention and radiological protections can improve the preventing effects of community medical, decrease the radiologieal level, which is helpful to the physical and psychological health of occupational population, hospitalized patients and the community public masses near our center.