心脏射频消融术中床旁介入护士辐射强度分层图设计

The design of radiation intensity stratification diagram for bedside interventional nurse during the performance of cardiac radiofrequency ablation

目的 探讨心脏射频消融(RFA)术中DSA机不同采集帧数对术中患者左侧床旁配合护士不同站立位置辐射强度的大小及衰减情况,并绘制出辐射强度分层图,以便为介入护士的辐射防护提供指导,进而减少辐射。方法 基于标准体模下,模拟心脏RFA,依次使用3种不同采集帧数,测量患者左侧床旁不同水平及垂直位置(共77个位置)辐射强度参数,共获取数据231组,并进行观察性分析、研究、绘图和总结。结果 不同采集帧数在相同床旁位置产生的辐射强度差异有统计学意义(P<0.05),且辐射强度与帧数大小呈正相关性,辐射强度乘以帧数增加的相应倍数后,3组数据差异无统计学意义(P>0.05);在相同的采集帧数下,与射线发射球管不同水平位置产生的辐射强度差异有统计学意义(P<0.05),且辐射强度与离射线发射球管水平距离大小呈负向相关性;辐射强度分层图绘制成为可能。结论 辐射强度分层图的设计应用可为介入护士提供射线辐射规避指导。

Objective To investigate the effect of different DSA collection frames on the radiation intensity and attenuation upon the coordination nurse standing at the left bedside at different positions during the performance of cardiac radiofrequeney ablation （RFA） and to draw out a stratified map of radiation intensity in order to provide guidance for interventional nurses in radiation protection, thereby reducing radiation dose. Methods Simulation of cardiac RFA based on standard phantom was conducted. By using 3 different sampling frames in turn, the radiation intensity parameters at different levels and upright positions at the left bedside of the patient （77 positions in total） were respectively measured. A total of 231 sets of data were obtained. The data were analyzed, studied, plotted and summarized. Results Statistically significant differences in radiation intensity measured at the same position near the bed existed between different image collection frames （P〈0.05）, moreover, the radiation intensity had a parallel relationship with the image collection frames. The differences in the products （the radiation intensity multiplied by the corresponding increase in multiple frames） were not statistically significant between each other among the three sets of data （P〉0.05）. In the same collection frames, statistically significant differences in radiation intensity existed between different horizontal positions from the X-ray tube （P〈0.05）, moreover, the radiation intensity had a negative correlation with the horizontal distance from the X-ray tube. The stratified map of radiation intensity was drawn out. Conclusion The design and application of the radiation intensity stratification diagram can provide practical guidance for interventional nurses to avoid radiation rays.