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重症监护病房放射检查过程中的患者及工作人员剂量测定

Patient and staff dosimetry during radiographic procedures in an intensive care unit.

作者信息

Fernández Rosario, Moreno-Torres Miguel, Contreras Antonia M, Núñez María I, Guirado Damián, Peñas Luis

机构信息

Unidad de Cuidados Intensivos, Hospital Universitario San Cecilio, Granada, Spain.

出版信息

J Radiol Prot. 2015 Sep;35(3):727-32. doi: 10.1088/0952-4746/35/3/727. Epub 2015 Sep 7.

DOI:10.1088/0952-4746/35/3/727
PMID:26344655
Abstract

The performance of radiography in the Intensive Care Unit (ICU) may be associated with a certain level of radiation exposure for staff and patients in the unit. Little evidence on exposure levels is available in the literature. However, healthcare professionals in the ICUs at our centre tend to leave the room during radiographic examinations, potentially compromising patient care. The objectives of this study were to quantify dose levels within the ICU and to evaluate the performance of ICU x-ray studies according to patient dose measurements. This study was conducted in the 18-bed ICU of a third-level hospital. The scattering radiation due to mobile x-ray examinations was measured by using four personal thermoluminiscent dosimeters (TLDs). The dose area product (DAP) was measured at each examination using a transmission chamber installed on the diaphragm of the x-ray equipment. Based on the TLD readings and taking account of the error margin, the annual dose to patients and staff was less than 0.6 mSv. The value given by the DAP meter for chest x-rays was 94  ±  17 mGy cm(2); this value is well below the lower limit recommended by different agencies and committees. Exposure levels were found to be extremely low and pose no apparent risk to staff or to those in beds adjacent to the patients undergoing x-ray examinations, which were correctly performed in the unit.

摘要

重症监护病房(ICU)中的放射检查可能会使病房内的工作人员和患者受到一定程度的辐射暴露。文献中关于暴露水平的证据很少。然而,我们中心ICU的医护人员在放射检查期间往往会离开病房,这可能会影响患者护理。本研究的目的是量化ICU内的剂量水平,并根据患者剂量测量评估ICU X光检查的性能。本研究在一家三级医院的18张床位的ICU中进行。使用四个个人热释光剂量计(TLD)测量移动X光检查产生的散射辐射。每次检查时,使用安装在X光设备隔膜上的传输腔测量剂量面积乘积(DAP)。根据TLD读数并考虑误差范围,患者和工作人员的年剂量小于0.6 mSv。胸部X光检查的DAP计给出的值为94±17 mGy·cm²;该值远低于不同机构和委员会推荐的下限。发现暴露水平极低,对工作人员或与接受X光检查的患者相邻床位的人员没有明显风险,该科室的X光检查操作正确。

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