Hafez M A, Smith R M, Matthews S J, Kalap G, Sherman K P
St. James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK.
Arch Orthop Trauma Surg. 2005 Jun;125(5):330-5. doi: 10.1007/s00402-005-0807-5. Epub 2005 Apr 21.
Previous studies reported that the radiation exposure to the hands of orthopaedic surgeons was far below the acceptable limit. However, the risk could have been underestimated as some factors were overlooked, namely monitoring trainees during average workload, placing dosimeters over the most susceptible locations, measuring the cumulative dosage of radiation and considering the dose limit for non-classified workers.
We performed a prospective study in two centres to estimate the radiation dose to the hands of two consultant trauma surgeons and two trainees (one assisting and one operating) while performing 47 fluoroscopy-assisted procedures. We used validated thermoluminescent dosimeters (TLDs) rings and fingerstalls for monitoring the cumulative dosage.
Trainees were at higher risk while performing intramedullary nailing and during assistance. Higher radiation doses were recorded from dominant index fingers and particularly fingertips.
The risk of radiation exposure appears to be higher than previously reported. Fingertips are more susceptible to radiation exposure and should therefore be monitored in forthcoming studies.
先前的研究报告称,骨科外科医生手部所受辐射远低于可接受限度。然而,由于一些因素被忽视,风险可能被低估了,这些因素包括在平均工作量期间监测实习医生、将剂量计放置在最易受影响的部位、测量辐射累积剂量以及考虑非分类工作人员的剂量限值。
我们在两个中心进行了一项前瞻性研究,以估算两名创伤外科顾问医生和两名实习医生(一名协助、一名主刀)在进行47例透视辅助手术时手部所受的辐射剂量。我们使用经过验证的热释光剂量计(TLD)指环和指套来监测累积剂量。
实习医生在进行髓内钉固定手术及协助过程中面临更高风险。优势手食指尤其是指尖记录到更高的辐射剂量。
辐射暴露风险似乎比先前报告的更高。指尖更容易受到辐射暴露影响,因此在未来研究中应予以监测。