床旁防护屏在冠状动脉介入诊疗过程中对不同操作者的防护作用

目的 探讨床旁防护屏对冠状动脉介入诊疗过程中,第一及第二术者位置辐射剂量的屏蔽效果。方法 采用冠状动脉造影过程中常用的足位、右足位、左足位、头位、左头位、左侧位、右侧位7个体位,桡动脉途径,对标准仿真人模体进行曝光采集。测量高度125 cm,在不同采集体位时,测量有无床旁防护屏情况下的入射体表剂量率,采用t检验比较体表入射剂量率是否存在差异,并分别计算辐射剂量的屏蔽效果。结果 在无床旁防护屏情况下,各采集体位第一术者位置的剂量率高于第二术者(t=97.1~2 263.0,P<0.05);在有床旁防护屏情况下各采集体位(除左足位外)第一术者的剂量率低于第二术者(t=-80.9~275.1,P<0.05);床旁防护屏对第一、第二术者位置的辐射剂量屏蔽率范围分别为92.26%~99.36%、27.83%~97.90%。结论 采用床旁防护屏可有效降低操作者位置的辐射剂量,并改变了操作者站立区域的剂量分布,冠状动脉介入诊疗过程中应充分利用床旁防护屏,同时重点关注第二术者的防护。

The effect of the bedside protection against different operators in percutaneous coronary intervention

Objective To discuss the effect of the bedside shielding protection on the first and second operators against position radiation in percutaneous coronary intervention. Methods The surface entrance dosage rate for the first and second operators at 125 cm height with and without radiation protection shielding (provided separately) were measured. The t-test was used for statistical analysis of arithmetic mean values of dosage rates. And the effect of bedside shielding protection was calculated. Results The position radiation dosage rate at which the first operator exposed was significantly higher than that for the second in the case of no bedside protection (t=97.1-2 263.0, P<0.05), whereas the dosage rate at which the first operator (except for the left foot position) exposed was significantly lower than that for the second in the case of no bedside protection (t=-80.9-275.1, P<0.05). The shielding effect of bedside protection on the first and second operators was in the range of 92.26%-99.36% and 27.83%-97.90%, respectively. Conclusions The bedside protection may effectively reduce position radiation dose to patients and the use of bedside protection changed the trends in the dose distribution in operators' standing region. Attention should be focused on the radiation protection of the second operators in daily work by making full use of bedside protection.