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一种辐射吸收防护装置在减少外周血管介入手术中术者所受剂量方面的效果:一项单中心试点研究。

Efficacy of a radiation absorbing shield in reducing dose to the interventionalist during peripheral endovascular procedures: a single centre pilot study.

作者信息

Power S, Mirza M, Thakorlal A, Ganai B, Gavagan L D, Given M F, Lee M J

机构信息

Imaging and Interventional Radiology Department, Beaumont Hospital, Beaumont Rd, Dublin 9, Ireland.

出版信息

Cardiovasc Intervent Radiol. 2015 Jun;38(3):573-8. doi: 10.1007/s00270-014-0997-8. Epub 2014 Oct 4.

Abstract

PURPOSE

This prospective pilot study was undertaken to evaluate the feasibility and effectiveness of using a radiation absorbing shield to reduce operator dose from scatter during lower limb endovascular procedures.

MATERIALS AND METHODS

A commercially available bismuth shield system (RADPAD) was used. Sixty consecutive patients undergoing lower limb angioplasty were included. Thirty procedures were performed without the RADPAD (control group) and thirty with the RADPAD (study group). Two separate methods were used to measure dose to a single operator. Thermoluminescent dosimeter (TLD) badges were used to measure hand, eye, and unshielded body dose. A direct dosimeter with digital readout was also used to measure eye and unshielded body dose. To allow for variation between control and study groups, dose per unit time was calculated.

RESULTS

TLD results demonstrated a significant reduction in median body dose per unit time for the study group compared with controls (p = 0.001), corresponding to a mean dose reduction rate of 65 %. Median eye and hand dose per unit time were also reduced in the study group compared with control group, however, this was not statistically significant (p = 0.081 for eye, p = 0.628 for hand). Direct dosimeter readings also showed statistically significant reduction in median unshielded body dose rate for the study group compared with controls (p = 0.037). Eye dose rate was reduced for the study group but this was not statistically significant (p = 0.142).

CONCLUSION

Initial results are encouraging. Use of the shield resulted in a statistically significant reduction in unshielded dose to the operator's body. Measured dose to the eye and hand of operator were also reduced but did not reach statistical significance in this pilot study.

摘要

目的

本前瞻性试点研究旨在评估使用辐射吸收屏蔽装置降低下肢血管内介入手术中术者散射剂量的可行性和有效性。

材料与方法

使用一种市售的铋屏蔽系统(RADPAD)。纳入60例连续接受下肢血管成形术的患者。30例手术未使用RADPAD(对照组),30例使用RADPAD(研究组)。采用两种独立方法测量单个术者所受剂量。使用热释光剂量计(TLD)徽章测量手部、眼部和未屏蔽身体的剂量。还使用了带数字读数的直接剂量计测量眼部和未屏蔽身体的剂量。为考虑对照组和研究组之间的差异,计算了单位时间剂量。

结果

TLD结果显示,与对照组相比,研究组单位时间的中位身体剂量显著降低(p = 0.001),平均剂量降低率为65%。与对照组相比,研究组单位时间的中位眼部和手部剂量也有所降低,但差异无统计学意义(眼部p = 0.081,手部p = 0.628)。直接剂量计读数也显示,与对照组相比,研究组未屏蔽身体的中位剂量率有统计学显著降低(p = 0.037)。研究组的眼部剂量率降低,但差异无统计学意义(p = 0.142)。

结论

初步结果令人鼓舞。使用屏蔽装置使术者身体未屏蔽剂量有统计学显著降低。本试点研究中,术者眼部和手部的测量剂量也有所降低,但未达到统计学意义。

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