热释光片法测量粒子植入术后病房主管医生及护士敏感器官的受照射剂量研究

目的:用热释光片法测量接受125I粒子植入手术患者病房主管护士及主管医生敏感器官受照射剂量，找出相关影响因素。方法:测量对象为我院放射治疗科29例接受125I粒子植入手术患者病房主管护士（甲状腺及左右眼晶体）及主管医生敏感器官（甲状腺及左右眼晶体）。2018年05月08日至06月09日顺序入组29例我科室首次实行CT引导下125I粒子植入手术的患者，男14例，女15例，年龄44~88岁，中位年龄54岁。在125I粒子植入后将热释光片贴于病房主管护士及主管医生相应位置进行测量。结果:测量天数共计25天（25天内病房主管医生及护士左右眼晶体及甲状腺皮肤处受照射的累积剂量用于预测年累积剂量），用均值±标准差表示各敏感器官的受照射结果及按照每年年工作日（约为250天）累计计算结果如下:病房护士的甲状腺、左晶体及右皮肤处的24小时受照射剂量分别为（0.88±1.27） μSv、（1.35±2.52） μSv及（1.00±1.28） μSv；预计年受照射剂量分别为0.15 mSv、0.23 mSv及0.18 mSv；主管医生的甲状腺、左右晶体皮肤处的24小时受照射剂量分别为（0.75±1.24） μSv、（1.00±1.52） μSv及（1.10±1.65） μSv；预计年受照射剂量分别为0.12 mSv 、0.21 mSv 及0.22 mSv。结论:在术后患者使用防护用具的情况下:粒子个数、粒子活度及肿瘤中心至体表垂直距离分别与主管医生及病房护士的敏感器官皮肤处的受照射剂量无直接相关性。在术后患者应用防护用具的情况下病房护士与主管医生是安全的。

Study on the dose measurement of sensitive organs of doctors in charge and nurses in the ward after 125I seeds surgery by TLD

Objective:To measure the irradiation dose of sensitive organs of nurses in charge of ward and doctors in charge of patients undergoing 125I seeds operation by thermoluminescence method,and to find out the relevant influencing factors.Methods:The subjects were 29 patients taking in125I seed surgery in our hospital the sensitive organs(thyroid,right and left lens) of nurses in the ward and sensitive organs(thyroid,left and right lens) of doctors in charge.From May 8 to June 9,2018,29 patients(14 males and 15 females,aged 44~88 years,median age 54 years) underwent CT-guided 125I seed implantation for the first time in our department.After 125I seed implantation,the TLD was attached to the corresponding position of the ward nurse and the doctor in charge for measurement.Results:The measured days were 25 days,the results of irradiation of sensitive organs expressed by mean(mean value±standard deviation) and the cumulative results calculated according to annual working days(about 250 days) are as follows:the 24-hour irradiation doses of thyroid gland skin,left and right lens skin of nurses in ward were（0.88±1.27） μSv,（1.35±2.52） μSv and （1.00±1.28） μSv,respectively.The estimated annual irradiation doses were 0.15 mSv,0.23 mSv and 0.18 mSv,respectively.The 24-hour irradiation doses of thyroid gland skin,left and right lens skin of doctors in charge were （0.75±1.24） μSv,（1.00±1.52） μSv and （1.10±1.65） μSv,respectively.The estimated annual radiation doses were 0.12 mSv,0.21 mSv and 0.22 mSv,respectively.Conclusion:In the case of using protective devices after operation,the number of seeds,the activity of seeds and the vertical distance from the tumor center to the body surface are not directly related to the irradiated dose of sensitive organs skin of the doctors and nurses in the ward.It is safe for nurses and doctors in charge to use protective devices in patients after operation.