Bartal Gabriel, Sailer Anna M, Vano Eliseo
Department of Medical Imaging and Interventional Radiology, Meir Medical Center, Kfar Saba 44281, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.
Department of Radiology,Stanford University School of Medicine, Stanford, CA; Department of Radiology,Maastricht University Medical Center, Maastricht, Netherlands.
Tech Vasc Interv Radiol. 2018 Mar;21(1):2-6. doi: 10.1053/j.tvir.2017.12.002. Epub 2017 Dec 15.
Medical staff should not be exposed to the primary X-ray beam during fluoroscopy-guided interventional procedures (FGIP). The main source of staff exposure is scatter radiation from the patient, which can be significant. Although many aspects of X-ray exposure to the patient as well as occupational exposure to interventional radiologists and other staff are strongly regulated and monitored in most countries, it is surprising how loosely the labeling and testing of the protective aprons is regulated. Interventional radiologists (IRs) have to be experts in interventional radiology as well as in basic facts regarding ways to provide a satisfactory level of protection from occupational exposure. IRs, however, are not familiar with the apron testing methods. The accompanying documents provided with aprons by manufacturers may not be informative enough. Vendors often report apron effectiveness at a single beam quality and attenuation. The vendor reports repeatedly disagree with independent reports, which clearly show that the attenuation of these garments at other important unreported energies may be lower than expected. Better trust no one and check your protective garment yourself, or, better yet, consult a medical physicist when making purchasing decisions related to protective garments. Each interventionist should choose garments that are appropriately protective for that individual's practice. Review of past personal dosimetry results and consultation with a medical physicist can help the IR make the best decision. This article will help the reader to understand why all protective garments are not created equally, and provides some practical tools that will allow safe and healthy practice in FGIP.
在透视引导介入手术（FGIP）过程中，医护人员不应暴露于原发射线束。工作人员暴露的主要来源是患者的散射辐射，其可能相当可观。尽管在大多数国家，对患者的X射线照射以及介入放射科医生和其他工作人员的职业照射的许多方面都有严格的规定和监测，但令人惊讶的是，防护围裙的标签和测试规定却很宽松。介入放射科医生（IRs）必须既是介入放射学专家，又是有关提供令人满意的职业照射防护方法的基本事实方面的专家。然而，IRs并不熟悉围裙测试方法。制造商随围裙提供的附带文件可能不够信息丰富。供应商通常只报告围裙在单一射线质量和衰减情况下的有效性。供应商的报告一再与独立报告不一致，独立报告清楚地表明，这些防护服在其他未报告的重要能量下的衰减可能低于预期。最好不要轻信任何人，自己检查防护服，或者更好的是，在做出与防护服相关的购买决策时咨询医学物理学家。每位介入医生都应选择适合其个人操作的防护服。回顾过去的个人剂量测定结果并咨询医学物理学家可以帮助IR做出最佳决策。本文将帮助读者理解为什么并非所有防护服都是一样的，并提供一些实用工具，以便在FGIP中实现安全健康的操作。
