职业照射对介入治疗医务人员生物学效应指标的影响

Observation on biological effect indexes of interventional radiologists

目的探讨职业照射对介入治疗医务人员生物学效应指标的影响。方法对2017—2020年进行职业健康检查的873名介入治疗医务人员、548名隔室操作医务人员、433名放射工作岗位岗前体检人员(对照组)进行外周血淋巴细胞染色体畸变分析、微核率检测、血细胞计数、眼科检查,并对个人剂量进行监测。结果介入治疗组人均年有效剂量高于隔室操作组,差异有统计学意义(P<0.01)。介入治疗组无着丝粒断片、双着丝粒体、染色体总畸变检出率,明显高于隔室操作组和对照组,差异均具有统计学意义(P<0.05/3);介入治疗组眼晶状体异常率高于对照组,差异有统计学意义(P<0.05/3)。3组大部分血细胞指标数值差异无统计学意义(P>0.05)。不同工龄介入治疗组医务人员微核检出率和眼晶状体异常率随工龄的增加而增加(P<0.01);其余指标均未见有此趋势(P>0.05)。不同工龄隔室操作的放射医务人员各指标均未见有随工龄的增加而增加的趋势(P>0.05)。结论职业照射对介入治疗医务人员生物学效应指标有一定的影响,应加强介入治疗的辐射防护工作,减少电离辐射损伤效应。

Objective To investigate the influence of occupational radiation exposure on biological effect indexes of interventional radiologists.Methods During 2017 to 2020,873 medical staff engaged in interventional therapy,548 compartment operators and 433 newly staff(pre-job physical examination,as reference group)were analyzed for chromosome aberration of peripheral blood lymphocytes,micronucleus rate,blood cell count and ophthalmic examination,and personal radiation dose was monitored.Results The average annual effective dose of medical staff engaged in interventional therapy was higher than that of compartment operators(P<0.01).The detection rates of no centromeric fragment,bicentromere and total chromosome aberration of medical staff engaged in interventional therapy were significantly higher than those of compartment operators and of the members in reference group(P<0.05/3).The abnormal lens rate of medical staff engaged in interventional therapy was significantly higher than that of the reference group(P<0.05/3).There was no significant difference of most blood cell indexes among these three groups(P>0.05).Among medical staff engaged in interventional therapy,the detection rate of micronucleus and the abnormal rate of ocular lens increased with the working year(P<0.01),while there was no such trend of other indexes observed(P>0.05).There was no similar trends observed among compartment operators(P>0.05).Conclusions Higher occupational radiation exposure may have a certain impact on the biological effect index of medical staff engaged in interventional therapy,so it is necessary to strengthen the radiation protection and reduce the ionizing radiation damage effect.