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国际原子能机构关于介入程序中患者和工作人员辐射防护的行动计划:实现实践变革。

The International Atomic Energy Agency action plan on radiation protection of patients and staff in interventional procedures: Achieving change in practice.

机构信息

Konstantopoulio General Hospital, Agias Olgas 3-5, 14233 Nea Ionia, Greece.

Department of Radiology and Medicine, Columbia University, New York, USA.

出版信息

Phys Med. 2018 Aug;52:56-64. doi: 10.1016/j.ejmp.2018.06.634. Epub 2018 Jun 21.

Abstract

INTRODUCTION

The International Atomic Energy Agency (IAEA) organized the 3rd international conference on radiation protection (RP) of patients in December 2017. This paper presents the conclusions on the interventional procedures (IP) session.

MATERIAL AND METHODS

The IAEA conference was conducted as a series of plenary sessions followed by various thematic sessions. "Radiation protection of patients and staff in interventional procedures" session keynote speakers presented information on: 1) Risk management of skin injuries, 2) Occupational radiation risks and 3) RP for paediatric patients. Then, a summary of the session-related papers was presented by a rapporteur, followed by an open question-and-answer discussion.

RESULTS

Sixty-seven percent (67%) of papers came from Europe. Forty-four percent (44%) were patient studies, 44% were occupational and 12% were combined studies. Occupational studies were mostly on eye lens dosimetry. The rest were on scattered radiation measurements and dose tracking. The majority of patient studies related to patient exposure with only one study on paediatric patients. Automatic patient dose reporting is considered as a first step for dose optimization. Despite efforts, paediatric IP radiation dose data are still scarce. The keynote speakers outlined recent achievements but also challenges in the field. Forecasting technology, task-specific targeted education from educators familiar with the clinical situation, more accurate estimation of lens doses and improved identification of high-risk professional groups are some of the areas they focused on.

CONCLUSIONS

Manufacturers play an important role in making patients safer. Low dose technologies are still expensive and manufacturers should make these affordable in less resourced countries. Automatic patient dose reporting and real-time skin dose map are important for dose optimization. Clinical audit and better QA processes together with more studies on the impact of lens opacities in clinical practice and on paediatric patients are needed.

摘要

引言

国际原子能机构(IAEA)于 2017 年 12 月组织了第三次国际患者放射防护会议。本文呈现了介入程序(IP)会议的结论。

材料与方法

IAEA 会议采用全体会议系列,随后是各种主题会议。“介入程序中的患者和工作人员放射防护”会议主旨发言人介绍了以下内容:1)皮肤损伤风险管理,2)职业辐射风险,以及 3)儿科患者的 RP。然后,由报告人介绍与会议相关的论文摘要,随后进行公开问答讨论。

结果

67%的论文来自欧洲。44%为患者研究,44%为职业研究,12%为综合研究。职业研究主要集中在晶状体剂量测定上。其余的则是散射辐射测量和剂量跟踪。大多数患者研究都与患者暴露有关,只有一项关于儿科患者的研究。自动患者剂量报告被认为是剂量优化的第一步。尽管付出了努力,但儿科 IP 辐射剂量数据仍然稀缺。主旨发言人概述了该领域的最新成就和挑战。预测技术、熟悉临床情况的教育工作者进行的特定任务的靶向教育、更准确地估计晶状体剂量以及更好地识别高风险职业群体,是他们关注的一些领域。

结论

制造商在使患者更安全方面发挥着重要作用。低剂量技术仍然昂贵,制造商应使这些技术在资源较少的国家也能负担得起。自动患者剂量报告和实时皮肤剂量图对于剂量优化很重要。需要进行临床审计和更好的 QA 流程,以及更多关于晶状体混浊在临床实践中的影响以及儿科患者的研究。

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