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评估外科中心使用荧光透视设备时多学科团队所受的电离辐射暴露情况。

Evaluation of exposure of a multidisciplinary team to ionizing radiation due to the use of fluoroscopy equipment in a surgical center.

作者信息

Cury Caio Santiloni, Alves Allan Felipe Fattori, Mascarenhas Yvone Maria, Magon Maria de Fátima, Ruiz Raul Lopes, Trindade Filho José Carlos de Souza, Camargo Lucas Faconi, Pina Diana Rodrigues

机构信息

Laboratório de Física Aplicada ao Radiodiagnóstico, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil.

Núcleo de Física Médica e Radioproteção, Hospital das Clínicas, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil.

出版信息

Rev Bras Med Trab. 2021 Aug 4;19(2):165-172. doi: 10.47626/1679-4435-2021-576. eCollection 2021 Apr-Jun.

Abstract

INTRODUCTION

Ionizing radiation-producing equipment is used in surgical centers to guide invasive procedures. Technological advances have enabled improvements in image quality, which may be accompanied by increased radiation doses in the surgical team. Correct use of personal protective equipment and monitoring of radiation levels are required to a safe practice.

OBJECTIVES

To evaluate radiation exposure conditions in occupationally exposed persons working at the Surgical Center at Hospital das Clínicas da Faculdade de Medicina de Botucatu for implementation of radiation protection measures.

METHODS

Three different types of fluoroscopy equipment were used: C-arms, a dosimetric system with ionization chambers, and optically stimulated dosimeters. A three-stage evaluation was conducted, consisting of a first stage for observation, a second stage for estimation of kerma rate simulating exposure conditions, and a final stage for dosimetry to estimate the effective dose in workers.

RESULTS

The most frequent procedures and the disposition for each team member were determined. Kerma values were estimated for both the principal physician and the assistant physician. The maximum number of annual procedures was also estimated so that the dose limits are not exceeded.

CONCLUSIONS

Dosimetry for the surgical team is indicated as an approach to monitor occupational dose levels. The dose rates and effective dose found in this study are low but not negligible. Thus, proper use of equipment and periodic training for workers are still the best options for radiation protection.

摘要

引言

手术中心使用产生电离辐射的设备来引导侵入性手术。技术进步已使图像质量得到改善,但这可能伴随着手术团队辐射剂量的增加。安全操作需要正确使用个人防护设备并监测辐射水平。

目的

评估在Botucatu医学院临床医院手术中心工作的职业暴露人员的辐射暴露情况,以实施辐射防护措施。

方法

使用了三种不同类型的荧光透视设备:C形臂、带有电离室的剂量测定系统和光激励剂量计。进行了三阶段评估,包括第一阶段的观察、第二阶段模拟暴露条件估算比释动能率,以及最后阶段进行剂量测定以估算工作人员的有效剂量。

结果

确定了最常见的手术程序以及每个团队成员的配置。估算了主刀医生和助手医生的比释动能值。还估算了年度最大手术次数,以便不超过剂量限值。

结论

手术团队的剂量测定被认为是监测职业剂量水平的一种方法。本研究中发现的剂量率和有效剂量较低,但并非可以忽略不计。因此,正确使用设备和对工作人员进行定期培训仍然是辐射防护的最佳选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e086/8447647/08c1ab162ca4/rbmt-19-02-0165-g01.jpg

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