急性冠状动脉综合征介入患者辐射剂量分析

目的分析200例急性动脉综合征介入治疗患者受照射剂量,探讨病变部位、狭窄程度、年龄和手术医生等因素对辐射剂量的影响。方法回顾分析我院200例急性动脉综合征行介入治疗(PCI)患者所记录的剂量资料,随机配置的剂量检测系统记录剂量面积乘积(DAP)和累计剂量(CD),根据DAP值估算有效剂量(ED)。根据血管病变受累程度分为单一病变和复杂病变以及患者年龄分组(小于40岁组,40~60岁组及大于60岁组)、左右侧冠状动脉和第一操作医生对患者受辐射剂量的影响。结果①本次收录200例行PCI术者累积剂量CD值191~5524 mGy,平均值(1157±781)mGy;剂量面积乘积DAP值(12714~417228)mGy·cm^2,平均值(100690±63896)mGy.cm^2;有效剂量ED范围1.119~58.411 mSv,平均值(14±9)mSv。②单一病变相比复杂病变辐射剂量少,CD值、DAP值、ED值差异有统计学意义(P<0.05)。③左侧冠状动脉大于右侧冠状动脉(P<0.05)。④3个年龄组间各个剂量值方差分析差异无统计学意义(P>0.05)。⑤2组不同年资操作医生患者所受剂量差异无统计学意义(P>0.05)。结论急性冠状动脉综合征PCI术患者接受辐射剂量差异较大,主要与病变本身(包括病变部位和累计范围及变异等)因素相关。

Analysis of radiation dose in patients with acute coronary syndrome

Objective To analye the dose of radiation in 200 patients with acute arterial syndrome,the effects of lesion location,extent of stenosis,age and operation doctor on radiation dose were investigated.Methods The dose data recorded in 200 patients with acute arterial syndrome(PCI)were analyzed retrospectively.The DAP and the cumulative dose(CD)were recorded in the dose control system randomly,according to the DAP value,effective dose(ED).According to the degree of vascular disease involvementdivided into single lesion and complex disease and patient age group(less than 40 years old group,40 to 60 years old group and older than 60 years old group),left and right crown and the first operation of the patient affected by radiation dose.Results The cumulative dose in the 200 cases was from 191 to 5524 mGy,the average value was(1157±781)mGy.The DAP value of the dose area ranged from 12714 to 417228 mGy.cm^2,the average was(100690±63896)mGy.cm^2;The effective dose of ED range was 1.119~58.411 mSv,the average value of(14±9)mSv.Compared with single lesion,complex lesions have less radiation dose.The values of CD value,DAP and ED,had significant difference(P<0.05).The left coronary artery was greater than the right coronary artery(P<0.05).There was no significant difference between the three age groups in the analysis of the variance of each dose(P>0.05).There was no significant difference in dose between the two groups,in which the doctor with different seniority(P>0.05).Conclusion The dose of radiation in PCI patients with acute coronary syndrome is great,which is mainly related to the factors of the lesion itself(including the lesion site and the cumulative range and variation).