与家属沟通：重大钝性躯干创伤受害者的医疗辐射对胎儿的风险。
Communicating with the family: the risks of medical radiation to conceptuses in victims of major blunt-force torso trauma.
作者信息
Mann F A, Nathens A, Langer S G, Goldman S M, Blackmore C C
机构信息
Harborview Injury Prevention and Research Center, Department of Radiology, University of Washington School of Medicine, Seattle, USA.
出版信息
J Trauma. 2000 Feb;48(2):354-7. doi: 10.1097/00005373-200002000-00033.
BACKGROUND
Trauma surgeons must balance the risk and benefits of diagnostic radiographic procedures on potentially pregnant patients and should know the range and likelihood of effects that radiation might have on pregnancy.
METHODS
We present guidelines for assessing such radiation risks. Knowledge of a patient's pregnancy status and an estimate of radiation dose to the conceptus (low, < 10 mGy [milligray]; intermediate, 10-250 mGy; high, > 250 mGy) allow provisional assessment of radiation-induced risks.
RESULTS
Dose estimates may be estimated at 2 mGy per exposure (radiographs), 5 mGy per slice (computed tomography), and 10 mGy per minute of fluoroscopy, when the conceptus is within the x-ray field. A formal radiation exposure assessment is appropriate when provisional estimates exceed 10 mGy.
CONCLUSION
A simple qualitative dose assessment can inform clinical decisions and guide appropriate triage to more formal quantitative assessment.
背景
创伤外科医生必须权衡对潜在怀孕患者进行诊断性放射检查的风险与益处，并且应该了解辐射对妊娠可能产生的影响范围和可能性。
方法
我们提出了评估此类辐射风险的指南。了解患者的妊娠状态以及对胎儿所受辐射剂量的估计（低剂量，<10毫戈瑞[毫灰]；中等剂量，10 - 250毫戈瑞；高剂量，>250毫戈瑞）有助于对辐射诱发的风险进行初步评估。
结果
当胎儿处于X射线照射野内时，每次X线摄影（X光片）的辐射剂量估计约为2毫戈瑞，每层计算机断层扫描（CT）为5毫戈瑞，透视每分钟为10毫戈瑞。当初步估计超过10毫戈瑞时，进行正式的辐射暴露评估是合适的。
结论
简单的定性剂量评估可为临床决策提供依据，并指导进行适当的分类以便进行更正式的定量评估。
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