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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监测,为改善患者的辐射防护设计提供基础数据。方法对60例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。结果荧光照射时间范围为1.0～44.7min;ESD范围为2.6～283.5mGy;PSD范围为8.6～1 156.9 mGy,剂量-面积乘积(DAP)范围为1.5～170.1 Gy.cm2,有效剂量(ED)范围为0.2～23.8 mSv。照射野沿途剂量范围为0.1～371.6 mGy。CA+PTCA组的荧光照射时间、入射皮肤剂量(ESD)、最高皮肤剂量(PSD)、剂量-面积乘积(DAP)与有效剂量(ED)都大于CA组,差异有统计学意义(P<0.05)。不同动脉穿刺方式的荧光照射时间、ESD、PSD、DAP与有效剂量ED及照射野沿途剂量差别均无统计学意义。结论心血管病放射性介入操作时,对患者的辐射防护问题应该引起相关部门的思考。
Objective To monitor the dose of radiation and dose-related indicators of patients during cardiovascular intervention and provide the basic data for improving the radiation protection design of patients. Methods Sixty patients undergoing cardiovascular intervention were enrolled in this study. Patients were divided into two groups: coronary angiography (CA) and coronary angiography (CA), followed by percutaneous transluminal coronary angioplasty (PTCA) ), The TLD personal dosimeter was used to measure the field exposure time, the incident skin dose (ESD), the highest skin dose (PSD) and the dose-area product (DAP) Results Fluorescence time range was 1.0 ~ 44.7min, ESD range was 2.6 ~ 283.5mGy, PSD range was 8.6 ~ 1 156.9 mGy, DAP range was 1.5 ~ 170.1 Gy.cm2, effective dose (ED) 0.2 ~ 23.8 mSv. The irradiation dose ranged from 0.1 to 371.6 mGy. The time of fluorescence exposure, the incident skin dose (ESD), the highest skin dose (PSD), the dose-area product (DAP) and the effective dose (ED) of CA + PTCA group were all higher than those of CA group ). Fluorescent irradiation time, ESD, PSD, DAP and effective dose of ED in different arterial puncture methods and dose differences along the irradiation field were not statistically significant. Conclusions Radiological intervention in cardiovascular disease, the radiation protection of patients should cause the relevant departments to think.