冠状动脉介入诊疗中不同血管机型对操作者所受辐射剂量的影响

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摘要目的：探讨冠状动脉介入诊疗过程中不同型号的血管机对第一及第二术者位置辐射剂量的影响。方法：采用冠状动脉造影过程中常用的7个体位，桡动脉途径，对标准仿真人模体进行曝光采集。测量不同高度不同采集体位时，专用机和公用机在有无床旁防护屏情况下第一及第二术者位置的体表入射剂量率。采用配对t检验比较不同机型第一及第二术者体表入射剂量率的差异。结果：无床旁防护情况下，125 cm和155 cm高度时，公用机的体表入射剂量率（除第一术者155 cm高度足位、右足位及第二术者125 cm高度右足位，155 cm高度足位、右足位外）都大于专用机（P＜0.05）。有床旁防护情况下，125 cm和155 cm高度时，在足位、右足位、左侧位及右侧位2种机型第一术者都未测得体表入射剂量，公用机在头位未测得体表入射剂量；公用机第一术者125 cm、155 cm高度时左足位的体表剂量率都大于专用机（P＜0.05）；而专用机在125 cm处头位及左头位和155 cm处头位的体表入射剂量率大于公用机（P＜0.05）；对于第二术者，公用机的体表入射剂量率（除右足位外）都大于专用机的体表入射剂量率（P＜0.05）。结论：冠状动脉介入诊疗过程中，使用公用机时操作者所受剂量大于使用专用机时操作者所受剂量。在条件允许情况下尽可能采用专用机来进行冠状动脉介入诊疗过程，以减少操作者所受辐射剂量。

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	胡文豪
	王智廷
	曹国全
	黄伟剑
	郑祥武

关键词 ：冠状动脉介入诊疗, 不同机型, 体表入射剂量率, 辐射防护

Abstract：Objective: To discuss the effect of different imaging systems on radiation to the first and second operator s position dose in percutaneous coronary intervention. Methods: In this study, the measurements of the first and second operator’s surface entrance dose rate in 125 cm and 155 cm height were obtained in no and have radiation protection separately through transradial approach by special and public imaging system. The paired t test was used for statistical analysis of dose rate arithmetic mean values. Results: The operator’s surface entrance dose rate of public imaging system (except for the foot and right foot position of first operator in 155 cm height; the right foot position in 125 cm height and foot and right foot position in 155 cm height of second operator) was significantly higher than that of special imaging system in no bedside protection situation. In a bedside protection situation, the operator’s surface entrance dose rates of foot, right foot, left and right position of first operator in 125 and 155cm height in both systems were not detected. The dose rates of the left foot position of public imaging system in 125 cm and 155 cm height were higher than that of special imaging system. The dose rates of head and left head position in 125 cm height and head position in 155 cm height of special imaging system were higher than that of public imaging system. For second operator, the operator’s surface entrance dose rates of public imaging system were significantly higher than that of special imaging system. Conclusion: The operator’s radiation dose of public imaging system is significantly higher than that of special imaging system. In daily work the special imaging system should be used as much as possible so as to reduce the operators’ radiation dose.

Key words： percutaneous coronary intervention different imaging systems incident dose rate radiation protection

收稿日期: 2017-03-20

基金资助:浙江省自然科学基金资助项目（Y17H180046）

通讯作者: 郑祥武，教授，主任医师，硕士生导师，Email：zxwu111@sina.com

作者简介: 胡文豪（1968-），男，浙江苍南人，副主任医师。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2017/V47/I8/561

[1] 葛均波. 开拓新兴介入技术发展多元介入治疗[J]. 中国介入心脏病学杂志, 2013, 21(1): 1.
[2] SCIAHBASI A, ROMAGNOLI E, TRANI C, et al. Operator radiation exposure during percutaneous coronary procedures through the left or right radial approach: the TALENT dosimetric substudy[J]. Circ Cardiovasc Interv, 2011, 4(3): 226-231.
[3] MILLER D L, BALTER S, COLE P E, et al. Radiation doses in interventional radiology procedures: the RAD-IR study: part I:overall measures of dose[J]. J Vase Interv Radiol, 2003, 14(6): 711-727.
[4] 吴延庆, 许美珍, 李頣, 等. 冠状动脉造影投照体位与患者体型及心型关系的定量分析(英文)[J]. 中国组织工程研究与临床康复, 2008, 12(4): 779-782.
[5] 中华人民共和国国国家卫生和计划生育委员会. 医用X射线诊断放射防护要求: GBZ 130-2013[S]. 北京: 中国标准出版社, 2013.
[6] MILLER D L, VAñó E, BARTAL G, et al. Occupational radiation protection in interventional radiology: a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology [J]. Cardiovasc Intervent Radiol, 2010, 33(2): 230-239.
[7] KUON E, DAHM J B, EMPEN K, et al. Identification of less-irradiating tube angulations in invasive cardiology[J]. J Am Coll Cardiol, 2004, 44(7): 1420-1428.
[8] 王连生, 孙秀玲, 袁杨. 介入放射学X射线辐射场分布调查与分析[J]. 职业卫生与应急救援, 2002, 20(3): 158.
[9] 张琳, 朱建国, 闵楠, 等. 3种常见介入诊疗中放射工作人员有效剂量的估算[J]. 中华放射医学与防护杂志, 2011, 31(4): 391-394.
[10] BRASSELET C, BLANPAIN T, TASSAN-MANGINA S, et al. Comparison of operator radiation exposure with optimized radiation protection devices during coronary angiograms and ad hoc percutaneous coronary interventions by radial and femoral routes[J]. Eur Heart J, 2008, 29(1): 63-70.
[11] NAKASHIMA E, NERIISHI K, MINAMOTOA A, et al. A reanalysis of atomic-bomb cataract data, 2000-2002: a threshold analysis[J]. Health Phys, 2006, 90(2): 154-160.
[12] KIM K P, MILLER D L, BALTER S, et al. Occupational radiation doses to operators performing cardiac catheterization procedures[J]. Health Phys, 2008, 94(3): 211-227.
[13] VENNERI L, ROSSI F, BOTTO N, et al. Cancer risk from professional exposure in staff working in cardiac catheterization laboratory: insights from the National Research Council’s Biological Effects of Ionizing Radiation VII Report[J]. Am Heart J, 2009, 157(1): 118-124.
[14] Valentin J. Avoidance of radiation injuries from medical interventional procedures[J]. Ann ICRP, 2000, 30(2): 7-67.
[15] 王智廷, 曹国全, 闻彩云, 等. 冠心病介入治疗中操作者站立区域不同高度的剂量监测与评价[J]. 中华放射医学与防护杂志, 2013, 33(4): 436-437.
[16] ERTEL A, NADELSON J, SHROFF A R, et al. Radiation dose reduction during radial cardiac catheterization: evaluation of a dedicated radial angiography absorption shielding drape[J]. ISRN Cardiol, 2012, 2012: 769167.
[17] 王智廷, 曹国全, 缪妙, 等. 床旁防护屏在冠状动脉介入诊疗过程中对不同操作者的防护作用[J]. 中华放射医学与防护杂志, 2015, 35(9): 709-712.