小儿先天性心脏病介入治疗中辐射剂量的评价

目的测定小儿先天性心脏病介入治疗中患儿辐射剂量,探讨影响辐射剂量的因素及减低剂量的方法。方法 2011年1月～2011年7月接受先天性心脏病介入治疗的患儿共91例,分为三组包括房间隔缺损(ASD)36例、动脉导管未闭(PDA)25例、室间隔缺损(VSD)30例,通过收集所有病例的累积辐射剂量(CD,Gy),面积剂量乘积(DAP,Gy.cm2),透视时间F(t),min],观察各组之间的区别。结果 ASD、PDA、VSD三组介入治疗中患儿CD值分别是(0.15±0.10),(0.31±0.29),(0.37±0.18)Gy,DAP值分别是(15.78±10.50),(33.11±31.35),(37.69±21.56)Gy.cm2,透视时间分别为(8.64±5.10),(8.15±5.23),(10.47±7.18)min。CD值与DAP值三种介入方式比较,差异有统计学意义(P0.05),且VSD的CD值和DAP值明显高于ASD和PDA。透视时间比较,差异无统计学意义(P0.05)。不同术者,患儿的CD值、DAP值、透视时间差异明显。结论经导管介入治疗先天性心脏病动脉导管未闭、房间隔缺损、室间隔缺损是安全和疗效可靠的方法,但儿童患者对辐射更加敏感。操作者应通过操作技术水平,缩短透视时间减少辐射剂量。

Radiation dosage accepted by children during interventional treatment for congenital heart disease

Objective To estimate the radiation dose to which children are exposed during cardiac catheterizations for the treatment of congenital heart disease to analyze the factors affecting the radiation dose and to find out the measures to decrease the radiation dose.Methods 91 cases undergoing cardiovascular interventional procedures were collected from January to July 2011 in our hospital,including 36 atrial septal defect（ASD）,25 patent ductus arteriosus（PDA）,30 ventricular septal defect（VSD） to observe cumulative dose（CD）,dose area product（DAP）,fluoroscopy time and those differences.Results The cumulative dose of the three groups of children were（0.15±0.10）,（0.31±0.29）,（0.37±0.18） Gy,and DAP were（15.78±10.50）,（33.11±31.35）,（37.69±21.56） Gy·cm2,and fluoroscopy time was（8.64±5.10）,（8.15±5.23）,（10.47±7.18）min,respectively.CD values,DAP values and fluoroscopy time were quite different between different operators.Conclusion Intervention therapy for congenital heart disease,including patent ductus arteriosus,atrial septal defect,and ventricular septal defects is safe,effective and reliable,but children are more sensitive to radiation.Operators should improve skills and shortern radiation time to reduce dose.