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实时监测对介入放射学环境中工作人员剂量暴露的影响。

The Effect of Realtime Monitoring on Dose Exposure to Staff Within an Interventional Radiology Setting.

作者信息

Baumann Frederic, Katzen Barry T, Carelsen Bart, Diehm Nicolas, Benenati James F, Peña Constantino S

机构信息

Miami Cardiac & Vascular Institute (MCVI), Baptist Hospital of Miami, 8900 North Kendall Drive, Miami, FL, 33176, USA.

Clinical Science Interventional X-ray, Philips HealthCare, P.O. Box 10.000, 5680 DA, Best, The Netherlands.

出版信息

Cardiovasc Intervent Radiol. 2015 Oct;38(5):1105-11. doi: 10.1007/s00270-015-1075-6. Epub 2015 Mar 19.

Abstract

PURPOSE

The purpose of this study is to evaluate a new device providing real-time monitoring on radiation exposure during fluoroscopy procedures intending to reduce radiation in an interventional radiology setting.

MATERIALS AND METHODS

In one interventional suite, a new system providing a real-time radiation dose display and five individual wireless dosimeters were installed. The five dosimeters were worn by the attending, fellow, nurse, technician, and anesthesiologist for every procedure taking place in that suite. During the first 6-week interval the dose display was off (closed phase) and activated thereafter, for a 6-week learning phase (learning phase) and a 10-week open phase (open phase). During these phases, the staff dose and the individual dose for each procedure were recorded from the wireless dosimeter and correlated with the fluoroscopy time. Further subanalysis for dose exposure included diagnostic versus interventional as well as short (<10 min) versus long (>10 min) procedures.

RESULTS

A total of 252 procedures were performed (n = 88 closed phase, n = 50 learning phase, n = 114 open phase). The overall mean staff dose per fluoroscopic minute was 42.79 versus 19.81 µSv/min (p < 0.05) comparing the closed and open phase. Thereby, anesthesiologists were the only individuals attaining a significant dose reduction during open phase 16.9 versus 8.86 µSv/min (p < 0.05). Furthermore, a significant reduction of total staff dose was observed for short 51 % and interventional procedures 45 % (p < 0.05, for both).

CONCLUSION

A real-time qualitative display of radiation exposure may reduce team radiation dose. The process may take a few weeks during the learning phase but appears sustained, thereafter.

摘要

目的

本研究旨在评估一种新设备,该设备可在透视检查过程中提供实时辐射暴露监测,以减少介入放射学环境中的辐射。

材料与方法

在一个介入手术室中,安装了一个提供实时辐射剂量显示的新系统和五个独立的无线剂量计。在该手术室进行的每台手术中,主刀医生、住院医生、护士、技术员和麻醉师都佩戴这五个剂量计。在最初的6周间隔内,剂量显示关闭(封闭阶段),此后启动,进入为期6周的学习阶段和为期10周的开放阶段。在这些阶段中,从无线剂量计记录每个手术的工作人员剂量和个人剂量,并与透视时间相关联。对剂量暴露的进一步亚分析包括诊断性手术与介入性手术以及短时间(<10分钟)与长时间(>10分钟)手术。

结果

共进行了252台手术(封闭阶段n = 88,学习阶段n = 50,开放阶段n = 114)。比较封闭阶段和开放阶段,每透视分钟的总体平均工作人员剂量分别为42.79和19.81微希沃特/分钟(p < 0.05)。因此,麻醉师是开放阶段唯一剂量显著降低的人员,从16.9微希沃特/分钟降至8.86微希沃特/分钟(p < 0.05)。此外,短时间手术的工作人员总剂量显著降低了51%,介入性手术降低了45%(两者p均< 0.05)。

结论

辐射暴露的实时定性显示可能会降低团队辐射剂量。这个过程在学习阶段可能需要几周时间,但此后似乎会持续下去。

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