实时辐射监测装置对导管室操作人员辐射暴露的影响：实时监测研究在导管室使用过程中的辐射减少量。
Effect of a real-time radiation monitoring device on operator radiation exposure during cardiac catheterization: the radiation reduction during cardiac catheterization using real-time monitoring study.
机构信息
From the Department of Cardiovascular Diseases, VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, TX (G.C., A.C.P., M.A., A.K., T.T.M., B.V.R., M.R., D.S., L.M., R.L., R.G., D.H., A.M., K.S., S.B., E.S.B.); University of Heraklion, Heraklion, Greece (S.M.); Department of Biostatistics, College of Health Innovation, University of Texas at Arlington, Arlington, TX (D.J.C.); and Department of Cardiology, Penn State Hershey Medical Center, Hershey, PA (C.E.C.).
出版信息
Circ Cardiovasc Interv. 2014 Dec;7(6):744-50. doi: 10.1161/CIRCINTERVENTIONS.114.001974. Epub 2014 Nov 25.
BACKGROUND
The Radiation Reduction During Cardiac Catheterization Using Real-Time Monitoring study sought to examine the effect of a radiation detection device that provides real-time operator dose reporting through auditory feedback (Bleeper Sv; Vertec Scientific Ltd; Berkshire, UK) on patient dose and operator exposure during cardiac catheterization.
METHODS AND RESULTS
Between January 2012 and May 2014, 505 patients undergoing coronary angiography, percutaneous coronary intervention, or both were randomized to use (n=253) or no use (n=252) of the Bleeper Sv radiation monitor. Operator radiation exposure was measured in both groups using a second, silent radiation exposure monitoring device. Mean patient age was 65±8 years, most patients (99%) were men, and 30% had prior coronary artery bypass graft surgery. Baseline clinical characteristics were similar in the 2 study groups. Radial access was used in 18% and chronic total occlusion percutaneous coronary intervention constituted 7% of the total procedures. Median procedure time was 17 (12-27) minutes for diagnostic angiography, 42 (28-70) minutes for percutaneous coronary intervention, and 27 (14-51) minutes in the overall study population, with similar distribution between the study groups. First (9 [4-17] versus 14 [7-25] μSv; P<0.001) and second (5 [2-10] versus 7 [4-14] μSv; P<0.001) operator radiation exposure was significantly lower in the Bleeper Sv group. Use of the device did not result in a significant reduction in patient radiation dose. The effect of the Bleeper Sv device on operator radiation exposure was consistent among various study subgroups.
CONCLUSIONS
Use of a real-time radiation monitoring device that provides auditory feedback can significantly reduce operator radiation exposure during cardiac catheterization.
CLINICAL TRIAL REGISTRATION URL
http://www.clinicaltrials.gov. Unique identifier: NCT01510353.
背景
使用实时监测技术降低心脏导管检查中的辐射研究旨在检验一种辐射检测装置的效果，该装置通过听觉反馈（英国贝瑞克科学有限公司的 Bleeper Sv）为操作者实时报告剂量，从而降低心脏导管检查过程中的患者剂量和操作者辐射暴露。
方法和结果
2012 年 1 月至 2014 年 5 月，505 例接受冠状动脉造影、经皮冠状动脉介入治疗或两者联合治疗的患者被随机分为使用（n=253）或不使用（n=252）Bleeper Sv 辐射监测器组。在两组中均使用第二个无声辐射暴露监测器来测量操作者的辐射暴露。患者平均年龄为 65±8 岁，大多数患者（99%）为男性，30%有先前的冠状动脉旁路移植术史。两组患者的基线临床特征相似。18%的患者采用桡动脉入路，7%的患者为慢性完全闭塞经皮冠状动脉介入治疗。诊断性血管造影的中位手术时间为 17（12-27）分钟，经皮冠状动脉介入治疗的中位手术时间为 42（28-70）分钟，整个研究人群的中位手术时间为 27（14-51）分钟，两组之间的分布相似。第一（9[4-17]μSv 与 14[7-25]μSv；P<0.001）和第二（5[2-10]μSv 与 7[4-14]μSv；P<0.001）操作者辐射暴露在 Bleeper Sv 组中显著降低。该设备的使用并未显著降低患者的辐射剂量。该设备对操作者辐射暴露的影响在各个研究亚组中是一致的。
结论
使用提供听觉反馈的实时辐射监测设备可显著降低心脏导管检查中的操作者辐射暴露。
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