尼日利亚冈田体外冲击波碎石术期间工作人员的辐射防护措施。

Eze K C, Nzotta C C, Eze C U, Omordia N, Salami T A T, Okegbunam B

Department of Radiology, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.

Niger J Med. 2008 Jul-Aug;17(3):337-9. doi: 10.4314/njm.v17i3.37406.

BACKGROUND

The study was designed to find out the radiation protection practices of radiologists and other staff involved in the first extra-corporeal shock wave lithotripsy in Nigeria, performed at Igbinedion Hospital and Medical Research Centre, Okada.

METHODOLOGY

Some members of staff who were present when the extra-corporeal shock wave lithotripsy (ESWL) was used in the hospital at Okada were interviewed between November 2002 and August 2003. Radiology records of the hospital were studied. Literature search involved available publication on the procedure in local and international journals with interest in precautions to reducing radiation exposure.

RESULTS

Only lead apron and lead gloves were used by the radiologists for radiation protection and shielding during fluoroscopy procedures. The fluoroscopy was the screen type with TV monitor. Multiple sessions were used in several patients with multiple pre- and post- treatment radiographic studies including contrast studies with average of two sessions per patient. All the patients were adults aged between 26 and 65 years with mean age of 42.5 years. 627-6000 shock waves were delivered over 45-135 minutes at intensity of 143-19KV depending on patients build and the size of the stones. The sizes of the patients varied from very obese with large bulk to slim built. Radiation monitoring of the staff and patients was not done. Staff believed that radiation effect from the lithotripsy procedure was low therefore adequate radiation monitoring and radiation reducing alteration in the procedure was rarely adopted.

CONCLUSION

Extended fluoroscopy time, multiple fluoroscopy examinations, multiple treatment sessions and multiple x-ray examinations which increased both the patients' and staff's radiation exposures were noted. Proper radiation protection and monitoring of patients and staff are necessary to avoid the risks from low-level exposure to radiation such as in ESWL.

背景

本研究旨在了解在尼日利亚冈田的伊格贝尼迪翁医院和医学研究中心进行的首例体外冲击波碎石术中，放射科医生及其他相关工作人员的辐射防护措施。

方法

2002年11月至2003年8月期间，对在冈田医院使用体外冲击波碎石术（ESWL）时在场的部分工作人员进行了访谈。研究了该医院的放射学记录。文献检索涉及在国内外期刊上发表的有关该手术的文献，重点关注减少辐射暴露的预防措施。

结果

在荧光镜检查过程中，放射科医生仅使用铅围裙和铅手套进行辐射防护与屏蔽。荧光镜为带有电视监视器的屏幕型。对多名患者进行了多次治疗，包括治疗前和治疗后的多项影像学检查，其中包括造影检查，每位患者平均进行两次检查。所有患者均为成年人，年龄在26至65岁之间，平均年龄为42.5岁。根据患者体型和结石大小，在45至135分钟内以143至19千伏的强度发射627至6000次冲击波。患者体型各异，从非常肥胖到体型苗条。未对工作人员和患者进行辐射监测。工作人员认为碎石术的辐射影响较低，因此很少采用适当的辐射监测和减少辐射的手术改进措施。