2011-2014上海市四家儿童医院CT应用频度调查结果分析

目的 对上海市4家儿童医院CT应用频度进行调查,描述儿童CT检查的应用特点。方法 从4家医院的放射学信息系统（RIS）数据库中提取2011-2014年所有儿童患者的CT检查情况,描述受检者年龄、性别和检查部位的分布特征,分析受检者重复检查的结果,并对上海市4家儿童医院的儿童CT检查应用频度进行估算与分析。结果 共计有175 672名患儿在2011-2014年进行了249 350人次CT检查。其中男性（62%）受检总人次数多于女性（38%）。大多数患儿年龄为1~5岁,占总人次数的40.3%。婴儿（≤ 1岁）心脏CT检查占婴儿CT检查总人次数的14.5%,占心脏CT检查总人次数的63.0%。有33 634（19.1%）名受检者在4年内接受了2次及以上的CT检查。研究估计的2011-2014年上海市4家儿童医院的儿童CT检查应用频度分别为37.9、43.3、43.3、39.0人次/千人口。结论 近年来上海市4家儿童医院的儿童CT检查应用频度基本保持稳定。     

上海市2008年临床核医学的医疗照射水平分析

[目的]掌握上海市临床核医学诊断与治疗的医疗照射水平现状及其发展趋势。[方法]设计统一调查表格,普查上海市开展临床核医学诊疗的43家医疗机构的有关基本现状,具体调查2008年43家医疗机构的临床核医学诊疗工作量及其分布,以及受检者与患者的性别、年龄组分布。[结果]2008年上海市拥有各类核医学相关设备169台,从事临床核医学的工作人员为342人。全市核医学诊断年频率为6．63人次／千人口,居多的检查类型为骨显像、PET肿瘤显像、甲状腺显像等,男性比女性高25．6％。核医学诊断年频率随受检者年龄增长（0～15岁、16～40岁、〉40岁组）而增加。临床核医学的放射性药物治疗频率为0．41人次／千人口,女性比男性高62．5％。多数显像和功能检查的常用放射性核素为^99mTc;PET检查常用的放射性核素为^18F。甲状腺癌和甲亢治疗常用的放射性核素为^13I,二者典型放射性活度分别是5088MBq和237MBq。上海市临床核医学诊断的应用频率比1998年增加了91.8％;是1998年我国大陆平均水平的11．4倍。全市核医学的放射性核素治疗频率比1998年增加了182．8％;是1998年我国大陆平均水平的6．8倍多。[结论]上海市临床核医学诊断和治疗的发展速度很快,应切实加强临床核医学的医疗照射防护工作。     

秦山核电站运行对上海环境放射性影响评价

Objective To study the effect on the environmental radioactivity level and the health of the residents in Shanghai when Qinshan Nuclear Power Station(QNPS) has been in normal operational condition for 17 years. Methods The field monitoring and the sampling analytical method were used for monitoring the radioactivity level in outdoor environment, drinking water, food and soil. Results The outdoor natural radiation level and the radioactivity level in the sample of the environmental media were on the normal background level. There was no distinct change in the environmental radiation level of Jinshan Area when QNPS was in normal operational condition. The radioactivity level in the environmental media was far lower than the limit values specified by the national standard GB. The effective dose of the outdoor natural external exposure for the residents is about 0.102 mSv/a and the effective dose of the internal exposure from the artificial radionuclides 90Sr and 137Cs in food for the residents is about 0.488 μSv/a. Conclusions There is no effect of the radioactive contamination on the environmental radioactivity level and the health of the residents in Shanghai when QNPS has been in normal operational condition for 17 years.     

秦山核电站运行对上海环境放射性影响评价

Objective To study the effect on the environmental radioactivity level and the health of the residents in Shanghai when Qinshan Nuclear Power Station(QNPS) has been in normal operational condition for 17 years. Methods The field monitoring and the sampling analytical method were used for monitoring the radioactivity level in outdoor environment, drinking water, food and soil. Results The outdoor natural radiation level and the radioactivity level in the sample of the environmental media were on the normal background level. There was no distinct change in the environmental radiation level of Jinshan Area when QNPS was in normal operational condition. The radioactivity level in the environmental media was far lower than the limit values specified by the national standard GB. The effective dose of the outdoor natural external exposure for the residents is about 0.102 mSv/a and the effective dose of the internal exposure from the artificial radionuclides 90Sr and 137Cs in food for the residents is about 0.488 μSv/a. Conclusions There is no effect of the radioactive contamination on the environmental radioactivity level and the health of the residents in Shanghai when QNPS has been in normal operational condition for 17 years.     

头颈部、胸部CT扫描频次分布及其剂量水平研究

目的 通过调查研究,掌握上海市头颈部、胸部CT扫描频次分布及其剂量水平。方法 采用分层典型抽样的方法,以上海市的25家医院为调查对象,通过上海市放射卫生综合监测管理信息系统、各医院的医学影像信息系统（PACS）和医学信息系统（HIS）,收集受检者基本信息、检查部位、扫描参数、受检者剂量报告等信息,输入计算机进行处理和分析。结果 所调查的1 732 286人次的CT检查中,头颈部、胸部检查在儿童受检者占75%以上,在成年人受检者则占60%以上。对于成年人受检者,颅脑CT、眼部CT和胸部CT的CTDI_w的平均值分别为55.4 mGy、43.1 mGy和12.4 mGy,CTDI_vol的平均值分别为56.1 mGy、47.0 mGy和10.6 mGy。颅脑CT、耳道CT和胸部CT的剂量长度乘积（DLP）的平均值分别为603.4 mGy·cm、241.8 mGy·cm和293.6 mGy·cm。结论 CT检查中,头颈部、胸部所占比例很高,不同类型CT检查导致的剂量水平存在明显区别。     

秦山核电站运行对上海环境放射性影响评价

Objective To study the effect on the environmental radioactivity level and the health of the residents in Shanghai when Qinshan Nuclear Power Station(QNPS) has been in normal operational condition for 17 years. Methods The field monitoring and the sampling analytical method were used for monitoring the radioactivity level in outdoor environment, drinking water, food and soil. Results The outdoor natural radiation level and the radioactivity level in the sample of the environmental media were on the normal background level. There was no distinct change in the environmental radiation level of Jinshan Area when QNPS was in normal operational condition. The radioactivity level in the environmental media was far lower than the limit values specified by the national standard GB. The effective dose of the outdoor natural external exposure for the residents is about 0.102 mSv/a and the effective dose of the internal exposure from the artificial radionuclides 90Sr and 137Cs in food for the residents is about 0.488 μSv/a. Conclusions There is no effect of the radioactive contamination on the environmental radioactivity level and the health of the residents in Shanghai when QNPS has been in normal operational condition for 17 years.     

留置导尿管拔出前注入红汞预防尿潴留的临床观察

目的探讨拔出导尿管前膀胱内注射红汞的临床价值。方法选择心胸外科手术病人共 2 5 0例 ,拔出导尿管前膀胱内注入红汞 1 30例 ,对照组 1 2 0例 ,观察排尿恢复时间及排尿情况。结果实验组拔管后平均排尿时间 99 88± 4 8 6 7min ,对照组拔管后平均排尿时间 1 5 5 95± 70 39min ,实验组排尿恢复时间明显优于对照组 ,差异有显著性意义 (P <0 0 0 0 5 )。排尿情况 ,实验组自然排尿成功 1 2 8例 (98 4 6 % ) ,对照组自然排尿成功 95例 (79 1 7% )。结论实验组拔出导尿管后 ,排尿时间早 ,且无尿潴留发生 ,值得推广     

监测受检者入射体表剂量的热释光方法的质量保证

[目的]为保证医疗照射剂量监测结果的可靠性,开展热释光剂量（thermoluminescence dosimetry,TLD）方法的质量保证研究。[方法]在次级标准剂量学实验室进行TLD的分散性、剂量线性和能量响应特性实验;通过建立标准化退火和测量程序并对设备进行定期校正来控制监测质量。[结果]经分档后各档TLD的灵敏度差异〈4％;在0．3～20mGy的剂量范围内,所用TLD具有理想的剂量线性（R^2=0．9999）;在医用诊断X射线常见的能量范围内,所用TLD的能量响应变化〈1．0％;盲样测量结果表明,TLD的测量值与约定真值偏差在-2．55％～0．12％之间。[结论]通过加强TLD的质量保证,可以有效提高x射线诊断受检者入射体表剂量监测结果的可比性和准确性。     

硬膜外阻滞剖宫产术中寒战的探讨

硬膜外阻滞剖宫产是目前产科手术主要的麻醉方法，但手术中常常出现寒战现象，给患者带来感觉上的不适和一定的危害。我院2005年共收治200例产科手术患者，现将其临床资料分析如下。