心血管介入患者的医疗照射水平
Level of Medical Radiation Received during Cardiovascular Intervention
-
摘要:
目的 分析心血管介入诊疗中患者的医疗照射水平, 探讨相应的辐射防护对策。 方法 回顾性分析262例共 4组患者(组 1:单行冠状动脉造影术; 组 2:冠状动脉造影 +球囊预扩张和支架置入术; 组 3:心脏起搏器置入、更换术; 组 4:电生理检查 +射频消融术), 测算不同类别心血管介入诊疗的剂量与面积之积(dose-area product, DAP,mGycm2)和空气比释动能(air kerma, AK, mGy), 用 Monte-Carlo转换系数从剂量与面积之积估算有效剂量。 结果 DAP 值、AK 值、有效剂量均以组 2 最高, 分别为(131 941.91& #177;112 242.64)mGycm2、(1 131.07& #177;635.75)mGy、(18.47& #177;15.71)mSv; 均以组 3 最低, 分别为(32 045.50& #177;57 475.17)mGycm2、(158.98& #177;379.50)mGy、(4.49& #177;8.05)mSv; 各组中个体的辐射暴露差异均较大。透视时间以组 4最长, 为(17.03& #177;3.35)min。摄影帧数以组 2最多, 为(787.12& #177;316.53)帧;组 4最少, 仅为(3.55& #177;6.27)帧。 结论 不同类别心血管介入诊疗, 患者的医疗照射水平差异较大。患者所受辐射剂量较高, 应采取适当防护措施, 有效防范患者可能受到的潜在电离辐射危险。 Abstract:Objective To measure the medical radiation level received by patients during diagnosis and treatment of cardiovascular intervention, and probe into the countermeasures for protection. Methods A total of 262 cases were divided into 4 groups by the type of cardiovascular interventions they received (Group 1, single coronary angiography; Group 2, coronary angiography + coronary artery pre-expansion and stent implantation; Group 3, pacemaker implantation and replacement; Group 4, electrophysiology examination and radio frequency ablation). Dose-area product (DAP, mGycm2) and air kerma (AK, mGy) were analyzed retrospectively. Effective dose was estimated by Monte-Carlo conversion coefficient from DAP. Results DAP, AK and effective dose were highest in Group 2, (131941.91& #177;112242.64) mGycm2, (1131.07& #177;635.75) mGy, and (18.47& #177;15.71) mSv, respectively; and were lowest in Group 3, (32045.50& #177;57475.17) mGycm2, (158.98& #177;379.50) mGy, and (4.49& #177;8.05) mSv, respectively. There were significant differences in individual radiation exposure among these four groups. Fluoroscopy time was longest in Group 4, (17.03& #177;3.35) min. Number of radiography frame was most in Group 2 (787.12& #177;316.53) and least in Group 4 (3.55& #177;6.27). Conclusion There is a great difference in the medical radiation level among patients who receive different cardiovascular interventions. As high doses of radiation are received during interventional diagnosis and treatment, appropriate protective measures are necessary to prevent them from potential risk of ionizing radiation.
下载:
