Sikand Manoj, Stinchcombe S, Livesley P J
King's Mill Hospital, Sutton in Ashfield, Nottinghamshire, UK.
Ann R Coll Surg Engl. 2003 Nov;85(6):422-5. doi: 10.1308/003588403322520852.
There are national guidelines issued by all hospital radiology departments concerning the use of gonadal protection shields for taking X-rays of the pelvis. It is important to follow these guidelines especially when paediatric X-rays are taken. Gonads are very susceptible to radiation as they fall directly in the line of radiation exposure when pelvic X-rays are taken.
To examine whether these guidelines were being followed.
This audit considered 355 radiographs taken in a 6-month period on 149 patients, under the age of 16 years, attending the orthopaedic department at King's Mill Hospital.
In only 23% of the cases studied, the correct use of gonad protection shields had been performed. In 67% of the unprotected patients, the shields were not used at all. In the remainder, the shield was incorrectly applied. Out of all the patients, 45% had more than one X-ray thus exposing the gonads to unnecessary radiation. In addition, 8% of patients had a CT scan, 6% had fluoroscopy and 42% had radiographs of other regions of the body.
Guidelines should be adhered to as far as possible and efforts always be made to decrease radiation exposure. Application of the current guidelines excludes the first X-ray exposure of the female pelvis and of the pelvis of trauma patients from the use of shields, thus adding to the number of the X-rays done without protection.
所有医院放射科都发布了关于在进行骨盆X光检查时使用性腺保护罩的国家指南。遵循这些指南非常重要,尤其是在进行儿科X光检查时。性腺对辐射非常敏感,因为在进行骨盆X光检查时它们直接处于辐射暴露的路径上。
检查这些指南是否得到遵循。
本次审计考虑了在6个月期间对国王磨坊医院骨科的149名16岁以下患者进行的355次X光检查。
在仅23%的研究病例中,正确使用了性腺保护罩。在67%未受保护的患者中,根本未使用保护罩。在其余病例中,保护罩使用不当。在所有患者中,45%接受了不止一次X光检查,从而使性腺暴露于不必要的辐射中。此外,8%的患者进行了CT扫描,6%的患者进行了透视检查,42%的患者进行了身体其他部位的X光检查。
应尽可能遵守指南,并始终努力减少辐射暴露。当前指南的应用将女性骨盆的首次X光检查和创伤患者骨盆的X光检查排除在保护罩使用范围之外,从而增加了未受保护的X光检查数量。