基于医院计算机信息系统山东省17家医院的儿童CT检查频数构成分析

目的 随机抽取山东省8个地级市的17家医院的儿童CT检查频数进行调查，初步了解儿童CT检查频数构成。方法 参照并更改全国医疗照射统一的调查表，采用分层随机抽样方法，随机选取我省8个地级市的17家医院作为样本，调查内容包括：医疗机构级别、计算机信息管理系统获得的受检者诊疗信息等。结果 共调查45114名儿童，其中男孩27307名（占60.53%），女孩17807名（占39.47%）；婴儿组（< 1岁）儿童8091名（占17.93%），幼儿组（1～< 3岁）儿童8910名（19.75%），学龄前组（3～< 6岁）儿童7656名（占16.97%），青春期组（10～< 15岁）儿童20457名（占45.35%）。不同年龄段的儿童的照射频数的累积前两位为颅脑和胸部，照射频数分别为18398人次（35.4%）和15359人次（29.5%）。平扫为主要的CT扫描方式，扫描的频数为45194人次，占86.87%，增强的扫描频数为5200人次，占10.0%。增强扫描中扫描部位占前两位为：颅脑和胸部，分别占16.36%和13.20%。各不同年龄段中，学龄前期的重复检查比例最高，其中检查两次的占14.64%，检查三次的占2.49%；不同受检部位中，受检者重复检查比例最高的为冠脉血管造影。结论 儿童CT扫描频数较高，各相关部门应采取有力措施，优化医疗照射防护，降低辐射危害。

Analysis of the frequency of children's CT examination based on hospital computer information system in 17 hospitals in Shandong Province

Objective Randomly selected 17 hospitals in 8 prefecture-level cities in Shandong Province to investigate the frequency of CT examination of children and get a preliminary understanding of the frequency composition.Methods With reference to and modification of the national unified questionnaire on medical irradiation, 17 hospitals in 8 cities in Shandong Province were randomly selected as a sample by stratified random sampling method, the contents of the survey included the level of medical institutions and information on the diagnosis and treatment of examines obtained from the computer information management system, etc.Results A total of 45114 children were surveyed, of whom 27307 (60.53%) were boys and 17807 (39.47%) were girls; 8091 (17.93%) were in the infant group (< 1 year old), 8910 (19.75%) in the toddler group (1～< 3 years old), 7656 (16.97%) in the preschool group (3～< 6 years old), and 20457 children (45.35%) in the adolescent group (10～< 15 years old). The top two cumulative frequencies of irradiation in children of different ages were cranial and thoracic, with 18398 (35.4%) and 15359 (29.5%) irradiation frequencies, respectively. Plain scans were the predominant CT scanning modality, with 45194 (86.87%) scans and 5200 (10.0%) enhanced scans. The top two sites for enhanced scans were cranial and thoracic, accounting for 16.36% and 13.20% of the scans, respectively. Among the different age groups, the highest proportion of repeat examination was the preschool group, with 14.64% having two examinations and 2.49% three examinations; the highest proportion of repeat examinations among the different sites examined was coronary angiography.Conclusion Due to the high frequency of CT scans for children, relevant departments should take strong measures to optimize medical exposure protection and reduce radiation hazards.