van Rappard Juliaan R M, de Jong Tijmen, Hummel Willy A, Ritt Marco J P F, Mouës Chantal M
Department of Plastic and Reconstructive Surgery, Medisch Centrum Leeuwarden, Amsterdam, The Netherlands.
Department of Plastic and Reconstructive Surgery, Medisch Centrum Leeuwarden, Amsterdam, The Netherlands.
J Hand Surg Am. 2019 Jan;44(1):68.e1-68.e5. doi: 10.1016/j.jhsa.2018.05.010. Epub 2018 Jun 20.
During mini C-arm fluoroscopy, both the patient and surgical team are exposed to scatter radiation. The objective of this study was to quantify body, thyroid, and hand radiation exposure to surgeon and assistant during intraoperative use of flat panel mini C-arm fluoroscopy in hand and wrist surgical procedures.
Over 5 months, the surgeon's and assistant's radiation exposure was recorded during all osseous hand and wrist surgical procedures. Whole-body and thyroid radiation exposure were measured with 2 types of dosimeters: a photon thermoluminescence detector and a RaySafe i2 real-time dosimeter. Ring dosimeters were used to quantify hand radiation exposure.
Mini C-arm fluoroscopy was used in 94 surgical procedures. Total fluoroscopy time was 1,996 seconds and varied between surgical procedures (range, 1-152 seconds; median, 11 seconds). No thermoluminescence detector photon dosimeter exceeded the threshold limit of 0.1 mSv. The RaySafe i2 real-time dosimeters recorded a cumulated dose of 0.029 mSv for the body and 0.012 mSv for the thyroid position of the surgeon. The assistant received a cumulated dose of 0.011 mSv for the body and 0.011 mSv for the thyroid position. The ring dosimeters showed a cumulated dosage of 1.28 mSv for the surgeon and 0.20 mSv for the assistant.
Our results show that the surgeon's and assistant's body, thyroid, and hands were exposed to acceptable levels of scatter radiation during intraoperative use of the flat panel mini C-arm. The surgeon received the highest radiation exposure: 2.9% of the yearly radiation limits for the body, 0.05% for the thyroid position, and 2.56% for the hands. The assistant was exposed to less scatter radiation: 1.1% for the body, 0.04% for the thyroid, and 0.4% for the hands.
This study quantified radiation levels to which surgeon and assistant are exposed during mini C-arm fluoroscopy in hand and wrist surgical procedures.
在小型C形臂透视期间，患者和手术团队都会受到散射辐射。本研究的目的是在手部和腕部手术中使用平板小型C形臂透视时，量化外科医生和助手身体、甲状腺及手部所受的辐射剂量。
在5个多月的时间里，记录了所有手部和腕部骨科手术中外科医生和助手的辐射暴露情况。使用两种剂量计测量全身和甲状腺的辐射暴露：光子热释光探测器和RaySafe i2实时剂量计。使用指环剂量计来量化手部的辐射暴露。
94例手术中使用了小型C形臂透视。总透视时间为1996秒，不同手术之间有所差异（范围为1至152秒；中位数为11秒）。没有热释光探测器光子剂量计超过0.1 mSv的阈值限制。RaySafe i2实时剂量计记录的外科医生身体累积剂量为0.029 mSv，甲状腺部位为0.012 mSv。助手身体累积剂量为0.011 mSv，甲状腺部位为0.011 mSv。指环剂量计显示外科医生的累积剂量为1.28 mSv，助手为0.20 mSv。
我们的结果表明，在术中使用平板小型C形臂时，外科医生和助手的身体、甲状腺及手部所受的散射辐射水平在可接受范围内。外科医生所受辐射剂量最高：身体为年辐射限值的2.9%，甲状腺部位为0.05%，手部为2.56%。助手所受散射辐射较少：身体为1.1%，甲状腺为0.04%，手部为0.4%。
本研究量化了在手部和腕部手术中使用小型C形臂透视时外科医生和助手所受的辐射水平。
