介入手术患者不同部位受照剂量水平监测与分析

Monitoring and analysis of radiation doses in different parts of the body of patients undergoing interventional therapy

目的观察介入手术患者不同部位X射线受照剂量水平,为医疗辐射防护提供科学依据。方法选择3家三甲医院进行介入手术患者57例。57例患者中,施行冠状动脉造影(CAG)33例,肝动脉栓塞术(TACE)13例,经皮肝穿胆道引流术(PTCD)11例。采用氟化锂热释光探测仪测量患者甲状腺、左胸、会阴、左手臂的X射线受照剂量。结果 CAG、TACE、PTCD组患者甲状腺、左胸部、会阴表面受照剂量比较,差异均有统计学意义(P<0.05),CAG组甲状腺受照剂量均高于PTCD组,左胸部受照剂量均高于TACE、PTCD组,而TACE组会阴受照剂量均高于CAG、PTCD组(P<0.05)。3家不同医院接受监测患者的甲状腺、左胸部表面受照剂量比较差异有统计学意义(P<0.05),A医院患者左胸部受照剂量均高于B、C医院(P<0.05),而C医院患者甲状腺受照剂量高于A医院(P<0.05)。3家医院介入手术时X射线的曝光时间、管电压比较,差异有统计学意义(P<0.05),A医院的曝光时间均长于B、C医院(P<0.05),3家医院使用的X射线管电流比较,差异无统计学意义(P>0.05)。结论不同医院接受不同介入手术患者的不同部位的表面受照射剂量不同,应加强对介入手术患者的放射防护工作,以降低患者受照剂量水平。

Objective To investigate the surface radiation doses in patients undergoing interventional therapy,aiming at providing scientific basis for medical radiation protection. Methods Fifty-seven patients treated with interventional therapy at three hospitals（ all graded as Third Grade Class A） in Guangxi were selected. Among them,33 were performed with coronary angiography（ CAG）,13 with hepatic artery embolization（ TACE）,and 11 with percutaneous transhepatic biliary drainage（ PTCD）. X ray surface radiation dose in thyroid,left chest,perineum and left arm of patients were measured by lithium fluoride thermoluminescent detector（ TLD）. Results There existed difference in radiation dose in thyroid,left breast,and perineum surface among three different intervention therapy（ P 〈0. 05）. The thyroid surface radiation dose in the CAG group was higher than that in the PTCD group,with its left thoracic surface radiation dose highest,while the perineum surface radiation dose in the TACE group was the highest in all three intervention therapy（ P 〈0. 05）. There also existed difference in radiation dose of thyroid and left chest surface among all three hospitals（ P 〈0. 05）,with the left chest surface radiation dose in A hospital the highest,while the thyroid surface radiation dose in C hospital was higher than that in A hospital（ P 〈0. 05）.The exposure time and the tube voltage of X ray were significantly different in all 3 hospitals（ P 〈0. 05）,with the exposure time in A hospital was the longest（ P 〈0. 05）. No significant difference in X ray tube current among 3 hospitals was observed（ P 〉0. 05）. Conclusion Surface radiation doses in different body parts of the patients receiving different interventional surgery in different hospitals vary,and radiation protection work for patients undergoing intervention therapy should be strengthened.