Luçon Adrien, Ghrairi Ayoub, Lecoq Guillaume, Idali Moussa, Huret Bruno, Richard Pascal, Morelle Jean-François
Service de Coronarographie, Centre Hospitalier Privé Saint Martin, 18 rue des Roquemeonts, 14000 Caen, France.
Radiat Prot Dosimetry. 2017 Apr 15;173(4):389-394. doi: 10.1093/rpd/ncw029.
Operator radiation protection during percutaneous coronary angiography (CA) is a growing concern in the catheterisation laboratory (cath lab). The purpose of this study was to evaluate the efficacy of an additional mobile leaded shield on operator radiation exposure during diagnostic CA. The study involved two operators from the same cath lab and patients scheduled for diagnostic coronary catheterisation over a period of 2 months. Procedures were performed with standard radiation equipment during the first month. An additional mobile lead shield was added during the second month. Radiation exposure was measured by three dosimeters positioned on the operator's left hand, on their chest under the lead apron and on lead glasses. The intra-operator results were compared. Ninety-nine per cent of the procedures were carried out by radial access. For Operators 1 and 2, the mobile shield, respectively, decreased the radiation dose to the eyes by 43 and 33 % and to the hands by 61 and 83 %. Thorax dose was less than the minimum measurable dose (<0.01 mSv) for each operator. There was no significant difference in total procedure duration, fluoroscopy time or contrast dose required between the two groups of patients. Improved operator radiation protection is an important issue in the face of increased occupational doses. Mobile leaded shield, combined with standard preventive measures, seems to be an effective additional option to reduce the radiation exposure during diagnostic CA.
在导管实验室中，经皮冠状动脉造影术（CA）期间的操作者辐射防护是一个日益受到关注的问题。本研究的目的是评估在诊断性CA期间，额外的移动铅屏蔽对操作者辐射暴露的防护效果。该研究涉及来自同一导管实验室的两名操作者以及计划在两个月内进行诊断性冠状动脉导管插入术的患者。第一个月使用标准辐射设备进行操作。第二个月增加了一个额外的移动铅屏蔽。通过放置在操作者左手、铅衣下胸部以及铅眼镜上的三个剂量计来测量辐射暴露。对操作者内部的结果进行了比较。99%的操作通过桡动脉途径进行。对于操作者1和操作者2，移动屏蔽分别使眼部辐射剂量降低了43%和33%，手部辐射剂量降低了61%和83%。每位操作者的胸部剂量均低于最小可测量剂量（<0.01 mSv）。两组患者之间在总操作时间、透视时间或所需造影剂剂量方面没有显著差异。面对职业剂量增加的情况，改善操作者辐射防护是一个重要问题。移动铅屏蔽与标准预防措施相结合，似乎是减少诊断性CA期间辐射暴露的一种有效的额外选择。
