心血管病介入操作时患者受照剂量研究

目的 对心血管介入手术中患者所受辐射剂量及与辐射剂量相关的指标进行采集和分析,为改善患者的辐射防护提供依据.方法 对在省属三级甲等医院进行的26例完整的心血管介入手术的患者进行临床数据采集,按手术类别分成冠状动脉血管造影术(CA)及行冠状动脉血管造影术(CA)后继续行经皮穿刺腔内冠状动脉成形术(PTCA)两组,采用TLD个人剂量计照射野矩阵测量法,检测患者荧光照射时间、入射皮肤剂量(ESD)、最高皮肤剂量(PSD)、剂量-面积乘积(DAP)等指标,用TLD测量在模拟心血管手术条件下体模器官剂量.结果 荧光透视时间为(17.7±15.6)min,范围为0.80～42.4 min;ESD范围为(159±138)mGy,4.40～459 mGy;PSD范围为(769±705)mGy,22.6～2.43×103mGy.CA+PTCA组的荧光照射时间、ESD、PSD均大于CA组,差异有统计学意义.最大皮肤受照剂量与透视时间有较好的相关性(r=0.84,P＜0.01).结论 心血管病放射性介入操作时,可通过透视时间来估算最大皮肤受照剂量.

Abstract：

Objective To collect and analyze the radiation dose to patients in cardiovascular interventional procedures and the radiation dose-related indicators,in order to provide a basis for improving radiation protection of patients.MethodsThe clinical data of 26 cases of complete cardiovascular interventional procedures was collected in the municipal Grade A Class Three hospitals,including coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA),and the patient-received radiation doses and other related factors was studied.TLD personal dosimeter radiation field matrix method was used to measure fluorescence time,the entrance skin dose (ESD),the peak skin dose (PSD),dosearea product (DAP) and other indicators.TLD was used to measure the organ dose of the phantom under the cardiovascular interventional procedure condition.ResultsThe fluoroscopy time was (17.7 ±15.6) min during the range of 0.80-42.4 min.The average entrance skin dose (ESD) was (159 ± 138)mGy during the range of 4.40-459 mGy.The peak skin dose (PSD) was (769 ± 705) mGy during the range of 22.6 - 2.43 × 103mGy.The fluorescence time,entrance skin dose (ESD) ,peak skin dose (PSD) of the group CA + PTCA are greater than the group CA and the difference has statistical significan.The peak skin dose and the fluoroscopy time have good linear correlation (r = 0.84,P ＜ 0.01 ).Conclusion The peak skin dose the patient received in cardiovascular interventional radiological operation can be estimated through the fluoroscopy time.

Radiation dose to patients in cardiovascular disease interventional procedures

Objective To collect and analyze the radiation dose to patients in cardiovascular interventional procedures and the radiation dose-related indicators, in order to provide a basis for improving radiation protection of patients. Methods The clinical data of 26 cases of complete cardiovascular interventional procedures was collected in the municipal Grade A Class Three hospitals, including coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA), and the patient-received radiation doses and other related factors was studied. TLD personal dosimeter radiation field matrix method was used to measure fluorescence time, the entrance skin dose (ESD), the peak skin dose (PSD), dose-area product (DAP) and other indicators. TLD was used to measure the organ dose of the phantom under the cardiovascular interventional procedure condition. Results The fluoroscopy time was (17.7?15.6) min during the range of 0.80-42.4 min. The average entrance skin dose (ESD) was (159?138)mGy during the range of 4.40-459 mGy. The peak skin dose (PSD) was (769?705)mGy during the range of 22.6-2.43?10³ mGy. The fluorescence time, entrance skin dose (ESD),peak skin dose (PSD) of the group CA PTCA are greater than the group CA and the difference has statistical significan. The peak skin dose and the fluoroscopy time have good linear correlation (r=0.84,P<0.01). Conclusion The peak skin dose the patient received in cardiovascular interventional radiological operation can be estimated through the fluoroscopy time.