Sharma Om P, Oswanski Michael F, Sidhu Ramandeep, Krugh Kerry, Culler Amy Sue, Spangler Matthew, Ethington Morgan, Stombaugh Heather A, Lauer Sherry K
Trauma Services, The Toledo Hospital, Toledo, Ohio, USA.
J Emerg Med. 2011 Dec;41(6):640-8. doi: 10.1016/j.jemermed.2011.03.004. Epub 2011 May 4.
Trauma patients are exposed to potentially high levels of low-dose radiation during radiologic studies.
To assess the cumulative effective dose (CED) of radiation exposure (RE) in 177 successive patients admitted to a trauma service from January 1 through February 28, 2006.
Patients received a total of 1505 radiographs and 400 computed tomography (CT) scans in the study period. The CED was 14.56 mSv (0.97 mSv radiographs, 13.59 mSv CT scans) per patient total length of stay (LOS). CED averaged 8.66 mSv in the first hour and 11.76 mSv in the first 24 h after arrival. The most commonly performed CT scan was brain (n = 147), followed by abdomen and pelvis (n = 80), and cervical spine (n = 69). CT scans of the brain and cervical spine were the most commonly performed combined imaging tests (35%). Twelve percent of patients received no radiographs, and 15% received no CT scans. Six or more CT scans were done in 6% of patients. RE increased with longer LOS (> 6 days vs. 3-5 days vs. 1 day, p < 0.05). "Pan-scans" (a combination of CTs of the brain, cervical spine, chest, abdomen, and pelvis) were done in 13% (n = 23) of patients. There was a higher total RE from CT scans (25.09 mSv ± 19.48 mSv vs. 4.93 mSv ± 14.20 mSv) in patients with injury severity score (ISS) > 9 vs. ≤ 9 ( p < 0.0001). First hour and first 24-h RE rates from radiographs were lower in patients younger than 15 years vs. 15-45 years and older-than-45-year age cohorts (p < 0.05).
In this study, CED was 14.56 mSv per patient. CT scans accounted for 21% of radiologic studies and 93% of CED. There was a higher CED rate in patients with ISS > 9 and longer LOS.
创伤患者在影像学检查期间可能会受到高水平的低剂量辐射。
评估2006年1月1日至2月28日期间连续收治于创伤科的177例患者的辐射暴露累积有效剂量（CED）。
在研究期间，患者共接受了1505次X光检查和400次计算机断层扫描（CT）。每位患者的总住院时长（LOS）对应的CED为14.56毫希沃特（X光检查为0.97毫希沃特，CT扫描为13.59毫希沃特）。到达后的第一个小时内CED平均为8.66毫希沃特，前24小时内为11.76毫希沃特。最常进行的CT扫描部位是脑部（n = 147），其次是腹部和骨盆（n = 80），以及颈椎（n = 69）。脑部和颈椎的CT扫描是最常进行的联合成像检查（35%）。12%的患者未接受X光检查，15%的患者未接受CT扫描。6%的患者进行了6次或更多次CT扫描。住院时长越长，辐射暴露量越高（住院时长>6天与3 - 5天与1天相比，p < 0.05）。13%（n = 23）的患者进行了“全景扫描”（脑部、颈椎、胸部、腹部和骨盆的CT联合检查）。损伤严重程度评分（ISS）>9的患者与≤9的患者相比，CT扫描的总辐射暴露量更高（25.09毫希沃特±19.48毫希沃特与4.93毫希沃特±14.20毫希沃特，p < 0.0001）。15岁以下的患者与15 - 45岁及45岁以上年龄组相比，X光检查在第一个小时和前24小时的辐射暴露率更低（p < 0.05）。
在本研究中，每位患者的CED为14.56毫希沃特。CT扫描占影像学检查的21%，占CED的93%。ISS>9且住院时长较长的患者的CED率更高。
