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对进行椎体成形术和后凸成形术的医务人员的四肢和眼晶状体剂量测定。

Extremity and eye lens dosimetry for medical staff performing vertebroplasty and kyphoplasty procedures.

作者信息

Struelens L, Schoonjans W, Schils F, De Smedt K, Vanhavere F

机构信息

Belgian Nuclear Research Centre, Radiation Protection Dosimetry and Calibration, Mol, Belgium.

出版信息

J Radiol Prot. 2013 Sep;33(3):635-45. doi: 10.1088/0952-4746/33/3/635. Epub 2013 Jun 27.

Abstract

Measurements of doses to hands, legs and eyes are reported for operators in four different hospitals performing vertebroplasty or kyphoplasty. The results confirm that occupational doses can be high for interventional spine procedures. Extremity and eye lens doses were measured with thermoluminescent dosimeters positioned on the ring fingers, wrists, legs and near the eyes of interventional radiologists and neurosurgeons, over a period of 15 months. Doses were generally larger on the left side for all positions monitored. The median dose to the left finger was 225 μSv per procedure, although a maximum of 7.3 mSv was found. The median dose to the right finger was 118 μSv, but with an even higher maximum of 7.7 mSv. A median left eye dose of 34 μSv (maximum 836 μSv) was found, while the legs received the lowest doses with a median of 13 μSv (maximum 332 μSv) to the left leg. Annual dose to the hand assessed by the cumulated doses almost reached the annual dose limit of 500 mSv, while annual dose to the eyes exceeded the eye lens dose limit of 20 mSv yr(-1). Different x-ray systems and radiation protection measures were tested, like the use of lead gloves and glasses, tweezers, cement delivery systems and a magnetic navigation system. These measurements showed that doses can be significantly reduced. The use of lead glasses is strongly recommended for protection of the eyes.

摘要

报告了在四家不同医院进行椎体成形术或后凸成形术的操作人员手部、腿部和眼睛的剂量测量结果。结果证实,介入性脊柱手术的职业剂量可能很高。在15个月的时间里,使用热释光剂量计对介入放射科医生和神经外科医生的无名指、手腕、腿部以及眼睛附近进行测量,以获取四肢和晶状体的剂量。在所监测的所有部位,左侧的剂量通常更大。每次手术左手手指的中位剂量为225μSv,尽管发现最大剂量为7.3mSv。右手手指的中位剂量为118μSv,但最大剂量更高,为7.7mSv。左眼的中位剂量为34μSv(最大836μSv),而腿部接受的剂量最低,左腿的中位剂量为13μSv(最大332μSv)。通过累积剂量评估的手部年剂量几乎达到了500mSv的年剂量限值,而眼睛的年剂量超过了20mSv·yr⁻¹的晶状体剂量限值。测试了不同的X射线系统和辐射防护措施,如使用铅手套、铅眼镜、镊子、骨水泥输送系统和磁导航系统。这些测量结果表明剂量可以显著降低。强烈建议使用铅眼镜来保护眼睛。

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