骨科医生术中经皮椎体强化术辐射防护及风险认知的研究

Study on radiation protection and risk perception of percutaneous vertebral augmentation in orthopedic surgeons

目的探讨骨科医生术中经皮椎体强化术辐射防护及风险认知的影响因素。方法采用方便抽样的方法,利用手机电子问卷APP对开展经皮椎体强化术的典型医院包括6家三级甲等医院、2家二级甲等医院109名骨科医生进行调查。结果骨科医生术中使用放射防护设备最多方式是移动铅防护屏(89.0%);铅围裙/背心(78.0%);铅防护颈套(61.5%)。术中曝光时采取防护措施最多方式是移动铅防护屏(69.7%);尽量缩短曝光时间(45.0%);撤到手术室外(39.5%)。在接受放射职业人员检查及培训中,50.5%接受个人剂量监测,49.5%没有监测;43.1%接受放射健康查体,56.9%没有接受;42.2%接受放射培训,57.8%没有接受。在辐射风险认知中,对CT、透视、拍片检查致患者剂量排序中,81.7%回答正确,18.3%回答错误。辐射对身体健康效应认知中危害最大的甲状腺疾病(83.5%);癌症(76.2%);血液系统(73.4%)。对辐射健康宣教最佳途径为专业培训(79.8%);现场讲座(47.7%);微信、微博(45.9%)。结论加强骨科放射人员职业照射防护及职业健康管理工作,提高骨科医生医疗照射知识及职业防护,加大专业培训及现场讲座管理力度,增强其参与主动性,从而更好的提高骨科医生自我防护及辐射风险认知的水平。

Objective To explore the influencing factors of radiation protection and risk perception of percutaneous vertebral augmentation surgery by in orthopedic surgeons.Methods By using the method of convenience sampling,109 orthopaedic surgeons were investigated in typical hospitals of percutaneous vertebral augmentation including 6 third-grade hospitals and 2 second-grade hospitals by using mobile phone electronic questionnaire APP.Results The most common methods used by orthopedic surgeons for radiation protection equipment were lead shield(89.0%);lead aprons/vests(78.0%);lead protective neck cover(61.5%).The most common way to take protective measures during intraoperative exposure was to move the lead shield(69.7%);minimize exposure time(45.0%);and evacuate outside the operating room(39.5%).During the examination and training of radiation professionals,50.5%received personal dose monitoring and 49.5%did not receive monitoring;43.1%received radiological health examination and 56.9%did not receive it;42.2%received radiation training and 57.8%did not accept it.In terms of the perception of radiation risk,81.7%of the patients answered correctly and 18.3%of the patients answered incorrectly in the dose sequencing caused by CT,fluoroscopy and radiography.Thyroid diseases(83.5%),cancer(76.2%)and blood system(73.4%)are the most harmful diseases in the recognition of the radiation effects on physical health.The best way to promote radiation health education is professional training(79.8%),on-site lectures(47.7%)and WeChat,Weibo(45.9%).Conclusion Strengthen the occupational radiation protection and occupational health management of orthopaedic radiologists,improve the medical radiation knowledge and occupational protection of orthopaedic surgeons,strengthen the management of professional training and on-site lectures,and enhance their participation initiative,so as to better improve the level of self-protection and radiation risk perception of orthopaedic surgeons.