Tsapaki Virginia, Faruque Ghulam Mohammed, Lim Soo Teik, Ngo Minh Hung, Nwe Nwe, Sharma Anil, Sim Kui-Hian, Srimahachota Suphot, Rehani Madan Mohan
Konstantopoulio Hospital, Athens, Attiki, Greece.
National Institute of Cardiovascular Diseases, Dhaka, Bangladesh.
Heart Asia. 2011 Jan 1;3(1):16-24. doi: 10.1136/ha.2009.001180. eCollection 2011.
Increasing use of interventional procedures in cardiology with unknown levels of radiation protection in many countries of Asia-Pacific region necessitates the need for status assessment. The study was part of an International Atomic Energy Agency (IAEA) project for achieving improved radiation protection in interventional cardiology (IC) in developing countries.
The survey covers 18 cardiac catheterisation laboratories in seven countries (Bangladesh, India, Malaysia, Myanmar, Singapore, Thailand and Vietnam). An important step was the creation of the 'Asian network of Cardiologists in Radiation Protection' and a newsletter. Data were collected on: radiation protection tools, number of IC laboratories, and annual number of various IC paediatric and adult procedures in the hospital and in the country. Patient radiation dose data were collected in terms of Kerma Area Product (KAP) and cumulative dose (CD).
It is encouraging that protection devices for staff are largely used in the routine practice. Only 39% of the angiographic machines were equipped with a KAP meter. Operators' initial lack of awareness on radiation-protection optimisation improved significantly after participation in IAEA radiation-protection training. Only two out of five countries reporting patient percutaneous coronary intervention radiation-dose data were fully within the international guidance levels. Data from 51 patients who underwent multiple therapeutic procedures (median 2-3) indicated a total KAP reaching 995 Gy.cm(2) (range 10.1-995) and CD 15.1 Gy (range 0.4-15.1), stressing the importance of dose monitoring and optimisation.
There is a need for interventional cardiology societies to play an active role in training actions and implementation of radiation protection.
在亚太地区许多国家，心血管介入手术的使用日益增加，但辐射防护水平不明，因此有必要进行现状评估。该研究是国际原子能机构（IAEA）一个项目的一部分，该项目旨在改善发展中国家介入心脏病学（IC）中的辐射防护。
该调查涵盖了七个国家（孟加拉国、印度、马来西亚、缅甸、新加坡、泰国和越南）的18个心导管实验室。重要的一步是创建“亚洲辐射防护心脏病学家网络”和一份时事通讯。收集的数据包括：辐射防护工具、IC实验室数量、医院及该国每年各类IC儿科和成人手术的数量。患者辐射剂量数据以比释动能面积乘积（KAP）和累积剂量（CD）的形式收集。
令人鼓舞的是，工作人员防护设备在常规操作中得到了广泛使用。只有39%的血管造影机配备了KAP测量仪。参与IAEA辐射防护培训后，操作人员最初对辐射防护优化的认识不足有了显著改善。在报告患者经皮冠状动脉介入治疗辐射剂量数据的五个国家中，只有两个国家的数据完全在国际指导水平之内。来自51名接受多次治疗手术（中位数为2 - 3次）患者的数据表明，总KAP达到995 Gy.cm(2)（范围为10.1 - 995），CD为15.1 Gy（范围为0.4 - 15.1），这凸显了剂量监测和优化的重要性。
介入心脏病学协会有必要在培训行动和辐射防护实施方面发挥积极作用。
