某医院心内科介入术者受照剂量监测分析

目的 了解某院心血管内科介入手术第一术者在手术过程中的受照剂量，为提高介入术者的辐射防护提供参考依据。方法 选择广西某院心血管内科5名介入手术第一术者为研究对象，按照国家标准《职业性外照射个人监测规范》（GBZ 128—2016），用热释光剂量计（TLD）监测介入术者的眼晶状体、左小手指、右小手指、左脚踝、甲状腺、左胸、会阴等共7个部位，记录每名术者的受照时间、手术例数、受照剂量，分别计算铅防护衣对X射线的衰减率，评估铅防护衣的屏蔽防护效果。结果 各监测部位受照剂量最高值分别为：眼晶状体2.04 mSv，左小手指为7.22 mSv，右小手指2.40 mSv，左脚踝为0.736 mSv，甲状腺为0.204 mSv，左胸0.054 mSv，会阴0.032 mSv；甲状腺、左胸部、会阴等部位铅防护衣对X射线衰减率平均值由高到低排序为：会阴（91.4%）、左胸部（85.1%）、甲状腺（71.2%）。结论 预估算，眼晶状体年受照剂量为24.5 mSv；除眼晶状体外，其余监测部位的年受照剂量均不超过国家标准限值，介入术者使用个人防护用品，可有效降低其受照剂量，应强化术者自身防护意识，正确使用个人防护用品，提高介入手术操作技术水平，减少不必要的照射。

The monitoring and analysis of occupational radiation doses in interventional radiology in a hospital

Objective To understand the radiation dose of the first operator in Cardiovascular Interventional Procedures in a hospital, and so as to provide reference for improving the radiation protection of operators. Methods To choose five first operator of interventional surgery on the cardiovascular medicine of a hospital in Guangxi. Under the national standard “Specifications of individual monitoring for occupational external exposure” (GBZ 128—2016), the thermoluminescent dosimeters (TLD) were used to monitor a total of 7 parts, such as the operators' eyes, left pinkie, right pinkie, left ankle, thyroid, left chest, perineum and the exposure time, surgical cases and exposure dose of each surgeon were recorded. The X-ray attenuation rate of lead protective clothing was calculated, and the shielding effect of lead protective clothing was evaluated. Results The highest dose values of each monitoring site were 2.04 mSv of ocular lens, 7.22 mSv of the left pinkie, 2.40 mSv of the right pinkie, 0.736 mSv of the left ankle, 0.204 mSv of the thyroid, 0.054 mSv of the left chest and 0.032 mSv of the perineum, respectively. The average X-ray attenuation rate of lead protective clothing in thyroid, left chest and perineum sites was ranked from high to low as follows: perineum (91.4%), left chest (85.1%), thyroid (71.2%). Conclusion It was estimated that the annual exposure dose of the lens was 24.5 mSv. Except for the lens, the annual dose of the other monitoring parts does not exceed the national standard limit. The use of personal protective equipment by the interventional surgeons can effectively reduce the exposure dose. Therefore, the awareness of personal protective equipment should be strengthened, the personal protective equipment should be used correctly, the technical level of interventional surgery should be improved, and the unnecessary irradiation should be reduced.