Sciahbasi Alessandro, Sarandrea Alessandro, Rigattieri Stefano, Patrizi Roberto, Cera Maria, Di Russo Cristian, Perone Francesco, Porretta Vanessa, Fedele Silvio, Romano Silvio, Penco Maria, Ferraiuolo Giuseppe
Interventional Cardiology, Sandro Pertini Hospital, Rome, Italy.
HSE Management, Rome, Italy.
Cardiovasc Revasc Med. 2018 Oct;19(7 Pt A):755-758. doi: 10.1016/j.carrev.2018.04.004. Epub 2018 Apr 6.
The use of adjunctive protective drapes placed on the patient protects the operating physician from scatter radiation during percutaneous coronary procedures (PCP). No data are available on the effect of these drapes for staff members' radio-protection.
To evaluate staff radiation exposure during PCP and the effect of adjunctive protective drapes on dose reduction.
The RADIANT study (NCT01974453) is a prospective, observational study evaluating operator radiation exposure during PCP using electronic dosimeter. In a sub-group of procedures all the staff members (II operator, nurse circulator and technologist) were also equipped with a dedicated electronic dosimeter.
From a total of 2028 procedures included in the RADIANT study, staff members' doses were available for 122 procedures (67 coronarography and 55 percutaneous coronary interventions). Median fluoroscopy time was 306 s (Interquartile range 155-526 s) and the dose area product (DAP) was 18.0 Gycm (10-35.5 Gycm). The radiation exposure was highest for the operating physician (6.7 μSv) and progressively lower for the nurse circulator (1.8 μSv), the II operator (1 μSv) and the technologist (0.7 μSv, p < 0.001). Protective pelvic drapes were used in 43 procedures and associated with a lower radiation exposure for all staff members (14 μSv vs 2.2 μSv for operating physician, p < 0.001, 1.7 μSv vs 0.49 μSv for II operator, p < 0.001, 2.16 μSv vs 0.93 μSv for nurse circulator, p = 0.02 and 0.85 μSv vs 0.39 μSv for technologist, p = 0.01).
The use of adjunctive protective drapes is effective in reducing radiation protection for all staff members during PCP.
在经皮冠状动脉介入手术（PCP）期间，使用置于患者身上的辅助防护巾可保护手术医生免受散射辐射。目前尚无关于这些防护巾对工作人员辐射防护效果的数据。
评估PCP期间工作人员的辐射暴露情况以及辅助防护巾对剂量降低的效果。
RADIANT研究（NCT01974453）是一项前瞻性观察性研究，使用电子剂量计评估PCP期间术者的辐射暴露情况。在一组手术中，所有工作人员（第二术者、巡回护士和技师）也配备了专用电子剂量计。
在RADIANT研究纳入的总共2028例手术中，有122例手术获得了工作人员的剂量数据（67例冠状动脉造影和55例经皮冠状动脉介入治疗）。透视时间中位数为306秒（四分位间距155 - 526秒），剂量面积乘积（DAP）为18.0 Gycm（10 - 35.5 Gycm）。手术医生的辐射暴露最高（6.7 μSv），巡回护士（1.8 μSv）、第二术者（1 μSv）和技师（0.7 μSv）的辐射暴露逐渐降低（p < 0.001）。43例手术使用了盆腔防护巾，所有工作人员的辐射暴露均较低（手术医生为14 μSv对2.2 μSv，p < 0.001；第二术者为1.7 μSv对0.49 μSv，p < 0.001；巡回护士为2.16 μSv对0.93 μSv，p = 0.02；技师为0.85 μSv对0.39 μSv，p = 0.01）。
在PCP期间，使用辅助防护巾可有效降低所有工作人员的辐射暴露。
