拉丁美洲脊柱外科医生对辐射暴露的认知与态度

Knowledge and Attitude Regarding Radiation Exposure Among Spine Surgeons in Latin America.

作者信息

Falavigna Asdrubal, Ramos Miguel Bertelli, Iutaka Alexandre Sadao, Menezes Cristiano Magalhães, Emmerich Juan, Taboada Nestor, Riew K Daniel

机构信息

Department of Neurosurgery, University of Caxias do Sul, Caxias do Sul, Brazil; Laboratory of Clinical Studies and Basic Models on Spinal Cord Pathologies, University of Caxias do Sul, Caxias do Sul, Brazil.

Laboratory of Clinical Studies and Basic Models on Spinal Cord Pathologies, University of Caxias do Sul, Caxias do Sul, Brazil.

出版信息

World Neurosurg. 2018 Apr;112:e823-e829. doi: 10.1016/j.wneu.2018.01.166. Epub 2018 Feb 1.

Abstract

BACKGROUND

Spine surgeons are exposed to high amounts of radiation from fluoroscopic procedures during their lifetime. In this study, we evaluated spine surgeons' knowledge of and attitude regarding radiation exposure during spine surgery.

METHODS

We developed a questionnaire including questions about surgeons' characteristics and knowledge of and attitude regarding radiation exposure during spine surgery. A survey was performed with the members of AOSpine Latin America. The main variables studied were specialty, years of experience, surgeon's position during fluoroscopy, and practices to reduce the patient's and surgeon's radiation exposure during surgery. The results were analyzed and compared among different specialties, levels of experience, and countries of origin.

RESULTS

The questionnaire was answered by 371 members of AOSpine Latin America from different countries. The sample was mostly from orthopedic surgeons (57.1%) and surgeons in practice for longer than 10 years (54.2%). Thyroid lead protection was used by 64.2% of the spine surgeons, lead glasses by 20.2%, and lead gloves by 7%. A dosimeter badge was never or only rarely used by 75.7%. The correct answer for surgeon position during lateral lumbar fluoroscopy was reported by only one-third of the surgeons. The reported rate of thyroid protector use was higher in surgeons from Brazil and Colombia compared with surgeons from Mexico and Argentina (P < 0.001), whereas the use of pulsed-mode fluoroscopy was higher in Mexico and Argentina compared with Brazil and Colombia (P < 0.0001).

CONCLUSIONS

Future efforts toward implementing educational programs in Latin America focused on safety strategies are needed to minimize intraoperative radiation exposure.

摘要

背景

脊柱外科医生在其职业生涯中会因透视检查而接触大量辐射。在本研究中,我们评估了脊柱外科医生对脊柱手术中辐射暴露的了解程度和态度。

方法

我们设计了一份问卷,其中包括有关外科医生的特征、对脊柱手术中辐射暴露的了解程度和态度的问题。对拉丁美洲AO脊柱学会的成员进行了一项调查。研究的主要变量包括专业、经验年限、透视检查时外科医生的位置,以及在手术中减少患者和外科医生辐射暴露的做法。对不同专业、经验水平和原籍国的结果进行了分析和比较。

结果

来自不同国家的371名拉丁美洲AO脊柱学会成员回答了问卷。样本主要来自骨科医生(57.1%)和从业超过10年的外科医生(54.2%)。64.2%的脊柱外科医生使用甲状腺铅防护,20.2%使用铅眼镜,7%使用铅手套。75.7%的人从未或仅很少使用剂量计徽章。只有三分之一的外科医生正确回答了腰椎侧位透视时外科医生的位置。与来自墨西哥和阿根廷的外科医生相比,来自巴西和哥伦比亚的外科医生报告的甲状腺保护器使用率更高(P<0.001),而与巴西和哥伦比亚相比,墨西哥和阿根廷的脉冲模式透视使用率更高(P<0.0001)。

结论

未来需要在拉丁美洲开展侧重于安全策略的教育项目,以尽量减少术中辐射暴露。

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