CAJ | 학술논문

目的测量冠状动脉造影8个投照体位在有与无床旁防护装置防护下术者所受辐射剂量,为冠心病介入治疗中减少术者辐射暴露提供参考.方法在第一及第二术者站位,距地面20至180 cm处,每隔20 cm放置一个实时剂量测量仪.采用冠状动脉造影8个体位投照,测量在有与无床旁防护装置防护下,术者在不同投照体位的不同高度接受辐射剂量情况.结果在第一术者位,除1.2m高度仍可测到较高剂量(剂量率0.35 ～4.78 mSv/h,屏蔽率27.67％～ 89.33％),其余各点屏蔽率均在91％以上.左前斜尾位、左前斜位、左前斜头位辐射剂量较高.第二术者位屏蔽率较第一术者位低,剂量峰值可出现在0.8、1.0及1.4m高度(剂量率0.27 ～ 1.86 mSv/h,屏蔽率30.34％～92.13％).右前斜尾位、左前斜尾位、正头位、左前斜位辐射剂量较高.结论床旁防护装置防护下,术者在左前斜尾位、左前斜位、左前斜头位、右前斜尾位的辐射暴露较高,应尽量少采用上述投照体位长时间曝光.同时应加强0.8～1.4m高度的辐射防护.
목적 측량관상동맥조영8개투조체위재유여무상방방호장치방호하술자소수복사제량,위관심병개입치료중감소술자복사폭로제공삼고.방법 재제일급제이술자참위,거지면20지180 cm처,매격20 cm방치일개실시제량측량의.채용관상동맥조영8개체위투조,측량재유여무상방방호장치방호하,술자재불동투조체위적불동고도접수복사제량정황.결과 재제일술자위,제1.2m고도잉가측도교고제량(제량솔0.35 ～4.78 mSv/h,병폐솔27.67％～ 89.33％),기여각점병폐솔균재91％이상.좌전사미위、좌전사위、좌전사두위복사제량교고.제이술자위병폐솔교제일술자위저,제량봉치가출현재0.8、1.0급1.4m고도(제량솔0.27 ～ 1.86 mSv/h,병폐솔30.34％～92.13％).우전사미위、좌전사미위、정두위、좌전사위복사제량교고.결론 상방방호장치방호하,술자재좌전사미위、좌전사위、좌전사두위、우전사미위적복사폭로교고,응진량소채용상술투조체위장시간폭광.동시응가강0.8～1.4m고도적복사방호.
Objective To measure the dose to the primary operator and assistant operators by employing eight beam projections commonly used in coronary angiography with and without radiation protection shields in order to supply helpful guidance on radiation protection in cardiac intervention.Methods From 20 to 180 cm above the ground at the primary and assistant operators' locations,a DoseAware personal dose meter was placed in terms of an increment of 20 cm to measure radiation dose.Eight commonly used beam projections were performed,including LAO (left anterior oblique) 45°,RAO (right anterior oblique) 30°,CRAN (cranial)25°,cranial LAO (LAO45°/25°),caudal LAO(LAO45°/ 25°),CAUD (caudal) 25°,cranial RAO (RAO30°/25°),caudal RAO (caudal RAO30°/25°).Under the two different conditions,with or without radiation protection shields,the doses to the operators in the selected beam projections were respectively recorded at nine measuring positions and the shielding factor were calculated.Results The primary operator was effectively protected with radiation protection shields.In the standing area of the primary operator,except for the position at the height of 120 cm (radiation dose rate:0.35-4.78 mSv/h;shielding factor:27.67％-89.33％),the shielding factor for each measuring position was above 91％.Higher radiation doses were found at caudal LAO,LAO,and cranial LAO.The shielding factor for the assisting operator was lower than for the primary operator.In the standing area of the assisting operator (radiation dose rate:0.27-1.86 mSv/h;shielding factor:30.34％-92.13％),the peak levels were found at the height of 80,100,140 cm.And caudal RAO,caudal LAO,CRAN,LAO were found to have received higher radiation doses.Conclusions Emphasis should be attached to the use of radiation shields in coronary angiography.With radiation protection shields,higher dose is still recorded in caudal LAO,LAO,cranial LAO,caudal RAO.Furthermore,it should be paid more attention to radiation protection at 80-140 cm height,and less prolonged exposure should be employed in those beam projections mentioned above.