介入放射诊疗操作医师所受剂量和健康状况调查

Exposure level and health condition of medical doctors engaging in intervention radiology

目的初步了解介入放射诊疗医师在介入手术时受外照射的影响。方法选取从事介入放射诊疗操作的医护人员36人为A组,放射科中辅助人员63人为B组,无X线接触史的健康者(同单位不从事放射工作的人员)45人为C组。测试A组人员头、甲状腺、手、铅衣胸内、铅衣胸外、腹部、背部七个部位的放射剂量;对三组人员白细胞计数、微核率、甲状腺功能、细胞和体液免疫状况进行比较分析。结果 A组人员人均接触年剂量为(0.381±0.177)m Sv,B组人员人均接触年剂量为(0.073±0.033)mSv,两组差异有统计学意义(P<0.01)。A组主要介入放射诊疗人员各X线照射部位受照剂量从多到少依次是手、胸(铅围裙外)、头部和甲状腺等。胸部防护围裙内外受照剂量比较,差异有统计学意义(P<0.01)。三组外周血白细胞计数均在正常值范围内,但A组最低,与B组、C组比较,差异有统计学意义(P<0.05)。与C组比较,A、B两组甲状腺功能指标T_3、T_4测得值降低,TSH测得值升高,差异均有统计学意义(P<0.05)。三组人员外周血淋巴细胞微核率比较,差异无统计学意义(P>0.05)。A组和B组T淋巴细胞亚群CD_3、CD_4测得值和CD_4/CD_8比值低于C组,CD_8测得值高于C组,差异均有统计学意义(P<0.05)。A、B组IgM测得值低于C组,IgE测得值高于C组,差异有统计学意义(P<0.05)。结论放射工作对医务人员(包括介入诊疗操作人员和放射科中辅助人员)健康均有一定的影响,介入诊疗操作人员接触的剂量更高。应注重介入放射诊疗操作人员的个人防护。

Objective To understand the exposure level and health condition of medical doctors engaging in intervention radiology.Methods Totally 36 medical doctors engaging in intervention radiology in the department of radiology,63 supporting staff in this department and 45 healthy staff in this hospital without any records of radiation exposure were investigated.The radiation dose on 7 body parts,including the head,the thyroid,the hands,the chest inside and outside of lead clothes,the abdomen,and the back of the medical staff in department of radiology were measured.The leucocyte count,micronucleus,thyroid function,and cell and humoral immunity function of these subjects were examined.Results The annual exposure dose of medical doctors engaging in intervention radiology was（0.381 ± 0.177）m Sv,which was higher than that of supporting staff（0.073 ± 0.033）m Sv（P〈0.01）.The exposed body parts of medical doctors engaging in intervention radiology,in order of exposure dose from high to low,were the hands,the chest outside of the lead clothes,the head and the thyroid gland.The dose measurement showed the exposure dose was different between inside and outside of the protective apron（P〈0.01）.The peripheral blood counts of these subjects were all in normal scope,but the medical doctors engaging in intervention radiology had lowest values compared with the supporting staff and healthy control（P〈0.05）,while there was no difference of peripheral blood lymphocyte micronucleus among these 3 groups（P〉0.05）.Compared with non-exposed persons,both medical doctors and supporting staff had decreased thyroid function,increased TSH level,decreased lg M level and increased Ig E level（P〈0.05）.T cell subsets of CD3,CD4,and CD4/CD8 in both medical doctors and supporting staff were lower compared with those in non-exposed control,while CD8 was higher（P〈0.05）.Conclusion All the staff of radiology department were affected by the radiation,and the medical doctors engaging in intervention radiology had a higher exposure.Exposure to radiation could cause health condition change and more control and/or protective measures should be taken.