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经皮椎体成形术中外科医生的辐射暴露。

Surgeon's radiation exposure during percutaneous vertebroplasty.

作者信息

Synowitz Michael, Kiwit Juergen

机构信息

Department of Neurosurgery, Helios Hospital Berlin, Germany.

出版信息

J Neurosurg Spine. 2006 Feb;4(2):106-9. doi: 10.3171/spi.2006.4.2.106.

Abstract

OBJECT

In this study the authors evaluated levels of radiation exposure to surgeons' protected and unprotected hands during fluoroscopically assisted vertebroplasty.

METHODS

The amount of radiation administered to 30 patients during 41 procedures in a controlled prospective trial over 6 months was assessed, comparing radiation exposure to the right and left hands in two neurosurgeons. Effective skin doses were evaluated using thermoluminescent finger dosimeters (ring dosimeters). The ratios of finger dosimeter exposure were compared between the glove-protected and unprotected left hands of two surgeons and both unprotected right hands. In addition, dose-area product (DAP) and fluoroscopy times were recorded in all patients. The mean treatment-effective dose to the surgeons' hands was 0.49 +/- 0.4 mSv in the glove-protected left hand and 1.81 +/- 1.31 mSv in the unprotected left hand (p < 0.05). The mean effective hand doses were 0.59 +/- 0.55 mSv in the unprotected right hand of the glove-protected surgeon and 0.62 +/- 0.55 mSv in the unprotected right hand of the control surgeon. The total corresponding fluoroscopy time was 38.55 minutes for the protected surgeon and 41.23 minutes for the unprotected one (p > 0.05). Lead glove shielding resulted in a radiation dose reduction of 75%. The total DAP for all procedures was 256,496 mGy/cm2 and 221,408 mGy/cm2 (p > 0.05) for the protected and unprotected surgeons, respectively.

CONCLUSIONS

This study emphasizes the importance of surgeons wearing lead glove protection on their leading hands during percutaneous vertebroplasty procedures and demonstrates a 75% reduction rate of exposure to radiation.

摘要

目的

在本研究中,作者评估了在透视辅助椎体成形术中外科医生受保护和未受保护手部的辐射暴露水平。

方法

在一项为期6个月的对照前瞻性试验中,对41例手术过程中的30例患者的辐射量进行了评估,比较了两名神经外科医生右手和左手的辐射暴露情况。使用热释光手指剂量计(指环剂量计)评估有效皮肤剂量。比较了两名外科医生戴手套保护的左手与未保护的左手以及两只未保护的右手之间的手指剂量计暴露比率。此外,记录了所有患者的剂量面积乘积(DAP)和透视时间。外科医生戴手套保护的左手的平均治疗有效剂量为0.49±0.4 mSv,未保护的左手为1.81±1.31 mSv(p<0.05)。戴手套保护的外科医生未保护的右手的平均有效手部剂量为0.59±0.55 mSv,对照外科医生未保护的右手为0.62±0.55 mSv。受保护外科医生的总透视时间为38.55分钟,未受保护的为41.23分钟(p>0.05)。铅手套防护使辐射剂量降低了75%。所有手术的总DAP,受保护外科医生为256,496 mGy/cm²,未受保护外科医生为221,408 mGy/cm²(p>0.05)。

结论

本研究强调了在经皮椎体成形术过程中外科医生在主导手上佩戴铅手套保护的重要性,并证明辐射暴露降低率为75%。

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