上海市^(125)I粒子植入治疗技术质量控制研究现状

The research status on technical quality-control of radioactive^(125)I seeds implantation in Shanghai

目的:分析探讨2022年上海市开展^(125)I粒子植入治疗技术的各医疗中心质量控制现状。方法:根据上海市核医学质量控制中心^(125)I粒子植入治疗技术评估表,对上海市16家医疗机构的20个相关科室的质量控制数据进行分析。结果:对医疗机构基本要求、人员基本要求、技术管理基本要求评估的36项质控内容中,最高符合率为100.00%(36/36),最低符合率为83.33%(30/36),同一家医院不同科室的管理和质量情况也有所不同;对于有关质控各项指标,植入指征正确率(平均)为98.75%,术前制订治疗计划率(平均)为94.74%,粒子活度复测率(平均)为25.13%,术后放射剂量验证率(平均)为83.81%,30 d内穿刺相关主要并发症发生率(平均)为5.67%,30 d内放射性损伤相关主要并发症发生率(平均)为0.85%,粒子植入治疗有效率(平均)为92.2%,30 d内全因死亡率(平均)为0.87%。2个月、4个月、6个月及1年的(平均)随访率分别为97.24%、91.9%、85.31%及71.91%,2个月、4个月、6个月及1年的(平均)生存率分别为96.81%、89.74%、81.31%及66.07%。结论:2022年上海市各医疗中心在^(125)I粒子植入治疗技术的质量控制中仍存在许多问题,各医疗中心应引起重视,按照上海市核医学质量控制中心^(125)I粒子植入治疗技术评估表的要求,完善科室规章制度,完全按照诊疗规范开展该项技术。

Objective:To explore and analyze the current situation of quality control of radioactive^(125)I seeds implantation technology in Shanghai.Methods:According to the evaluation sheet of^(125)I seeds implantation technology established by Shanghai Nuclear Medicine Quality Control Center,the data of 20 departments from 16 medical institutions was analyzed.Results:Among the 36 quality control contents evaluated for the basic requirements of medical institutions,personnel,and technical management,the highest compliance rate was 100.0%(36/36),and the lowest compliance rate was 83.33%(30/36),the management and quality situation of different departments in the same hospital also varies.For various indicators related to quality control,the average accuracy rate of implantation indications was 98.75%,the average preoperative treatment plan formulation rate was 94.74%,the average particle activity retest rate was 25.13%,the postoperative radiation dose verification average rate was 83.81%,the average incidence rate of major complications related to puncture within 30 d was 5.67%,the average incidence rate of major complications related to radiation injury within 30 d was 0.85%,and the average effective rate of particle implantation treatment was 92.2%,The all-cause mortality average rate within 30 days was 0.87%.The average follow-up rates for 2 months,4 months,6 months,and 1 year were 97.24%,91.9%,85.31%,and 71.91%,respectively.The average survival rates for 2 months,4 months,6 months,and 1 year were 96.81%,89.74%,81.31%,and 66.07%,respectively.Conclusion:In 2022,there were many problems in the quality control of^(125)I particle implantation therapy technology in all medical centers in Shanghai.All medical centers should pay attention to it.According to the requirements of the^(125)I particle implantation therapy technology evaluation form of nuclear medicine quality control center,medical centers should improve the department rules and regulations,and carry out the technology in full accordance with the diagnostic and therapeutic specifications.