Husák V, Petrová K, Masopust J, Myslivecek M
Klinika nukleární medicíny FN a LF UP, Olomouc.
Cas Lek Cesk. 1999 May 24;138(11):323-8.
Consistent with the worldwide development of nuclear medicine, in the Czech Republic in 1987 to 1996 partly the spectrum of used radiopharmaceutical preparations and their ratio changed. In the majority of radiopharmaceutical preparations the mean administered activity increased by 20 to 80% and the range of activities administered in different departments diminished somewhat. Adherence to principles of radiation protection of patients is assisted by guidelines of administered activities of radiopharmaceutical preparations laid down in new regulations on radiation protection valid in the CR from the middle of 1997. The radiation burden associated with the majority of examinations in nuclear medicine expressed as the effective dose is comparable with the radiation burden of radiodiagnostic examinations, only after administration of preparations with 131I, 201Tl, 67Ga and 111In it is markedly higher. Based on knowledge of the effective dose it may be concluded that the lifetime extra risk of a fatal tumour due to administration of radiopharmaceutical preparations is by two to three orders lower than the lifetime risk of spontaneous development of fatal tumours. A special feature of radiation risk is its hypothetical character--it is frequently projected into the distant future of human life, contrary to immediate non-radiation risks of some medical procedures and risks in the living environment which frequently are higher. Any examination using ionising radiation can be made only if the expected health benefit for the patient is significantly greater than the radiation risk. Excessive fear of radiation risk should not lead to refusal of justified examinations with possible subsequent serious health damage for the patient.
与核医学在全球范围内的发展相一致，1987年至1996年期间，捷克共和国使用的放射性药物制剂的种类及其比例在一定程度上发生了变化。在大多数放射性药物制剂中，平均给药活度增加了20%至80%，不同科室的给药活度范围有所缩小。自1997年年中起在捷克共和国生效的新的辐射防护法规中规定的放射性药物制剂给药活度指南，有助于遵守患者辐射防护原则。核医学中大多数检查的辐射负担以有效剂量表示，与放射诊断检查的辐射负担相当，只有在使用131I、201Tl、67Ga和111In制剂后，辐射负担才明显更高。根据有效剂量的知识可以得出结论，由于使用放射性药物制剂导致致命肿瘤的终身额外风险比致命肿瘤自然发生的终身风险低两到三个数量级。辐射风险的一个特殊特征是其假设性——它经常被投射到人类生命的遥远未来，这与一些医疗程序的直接非辐射风险和生活环境中的风险相反，后者往往更高。只有当预期对患者的健康益处明显大于辐射风险时，才能进行任何使用电离辐射的检查。对辐射风险的过度恐惧不应导致拒绝合理的检查，否则可能会对患者造成随后的严重健康损害。
