Cao Meng-Qiu, Zhang Xue-Bin, Zhuang Zhi-Guo, Zhou Wei, Xu Jian-Rong, Zhong Yi-Cun
1 Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
2 Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Br J Radiol. 2016 Jun;89(1062):20140448. doi: 10.1259/bjr.20140448. Epub 2016 Mar 24.
To introduce a method in which a long sheath is used instead of the traditional short sheath, to reduce the radiation exposure of operators in uterine artery embolization (UAE).
52 patients undergoing UAE were randomly divided into two groups before the procedure: an 11-cm short sheath was used in Group A (n = 25), and a 45-cm-long sheath was used in Group B (n = 27); the 45-cm-long sheath was only partly inserted such that the hub of the sheath was approximately 34 cm caudal to the groin puncture site. All the procedures were standard bilateral UAE operations through unilateral approach. The other parameters of the two groups were kept the same, including the fluoroscopy conditions and the pelvic radiation field size. The thermoluminescent personal dosemeters were attached to the left wrist and left outer side of the thyroid collar of the operator during each operation. The radiation exposure of the operator, procedure duration and fluoroscopy time of each procedure were recorded. Statistical analysis was performed using independent samples t-test.
The radiation exposure of both the left hand and thyroid of the operator was significantly reduced with the long sheath compared with the short sheath (89.5 ± 7.2 μGy vs 186.7 ± 12.6 μGy, p < 0.001, and 54.1 ± 5.5 μGy vs 63.9 ± 7.4 μGy, p < 0.001, respectively). No significant differences were found in the procedure duration and fluoroscopy time between the two groups (p > 0.1).
Using a long sheath in UAE could significantly reduce the radiation exposure to the interventionists without extending the procedure duration or fluoroscopy time.
For the first time, we introduce a simple and convenient method to reduce the radiation exposure of the operator in the UAE procedure.
介绍一种使用长鞘代替传统短鞘的方法，以减少子宫动脉栓塞术（UAE）中操作者的辐射暴露。
52例行UAE的患者在手术前被随机分为两组：A组（n = 25）使用11厘米短鞘，B组（n = 27）使用45厘米长鞘；45厘米长鞘仅部分插入，使鞘座位于腹股沟穿刺点尾侧约34厘米处。所有手术均通过单侧入路进行标准双侧UAE操作。两组的其他参数保持相同，包括透视条件和盆腔辐射野大小。每次手术期间，将热释光个人剂量计分别贴于操作者的左手腕和甲状腺防护颈圈的左侧。记录每个手术中操作者的辐射暴露、手术持续时间和透视时间。采用独立样本t检验进行统计分析。
与短鞘相比，使用长鞘时操作者左手和甲状腺的辐射暴露均显著降低（分别为89.5±7.2μGy对186.7±12.6μGy，p<0.001；54.1±5.5μGy对63.9±7.4μGy，p<0.001）。两组间手术持续时间和透视时间无显著差异（p>0.1）。
在UAE中使用长鞘可显著降低介入操作者的辐射暴露，且不延长手术持续时间或透视时间。
我们首次介绍了一种简单便捷的方法来减少UAE手术中操作者的辐射暴露。
