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剂量减少软件对透视引导下起搏器植入、封堵器植入和冠状动脉造影手术中患者和医护人员颞部剂量的影响。

Impact of dose reducing software on patient and staff temple dose during fluoroscopically guided pacemaker insertion, closure devices implantation and coronary angiography procedures.

机构信息

School of Chemistry and Physics, Faulty of Science, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia.

Cardiovascular Suites, Greenslopes Private Hospital, Ramsay Health Care, Newdegate Street, Greenslopes, Brisbane, QLD, 4120, Australia.

出版信息

Phys Eng Sci Med. 2022 Jun;45(2):589-599. doi: 10.1007/s13246-022-01126-2. Epub 2022 May 9.

Abstract

The aim of this study is to investigate the effectiveness of dose reducing software (ClarityIQ) on patient and staff dose during fluoroscopically guided cardiac procedures. Dose measurements were collected in a room without dose reducing software (n = 157) and compared with similar procedures performed in two rooms with the software (n = 1141). Procedures included diagnostic coronary angiography, percutaneous coronary intervention, deployment of cardiac closure devices (for occlusion of atrial septal defect, patent foramen ovale, and atrial appendage) and insertion of permanent pacemakers. The dose reducing software was found to be effective in reducing patient and staff dose by approximately 50%. This study has added to the limited literature reporting on the capability of dose reducing software to decrease radiation exposure during the implantation of cardiac closure devices, as well as demonstrating a reduction in dose to the cardiologist and nursing staff. Administrators should ensure timely upgrades to angiographic equipment to safeguard patients and staff against the potentially adverse effects of radiation exposure. Regardless of the use of dose reducing software, the mean occupational dose during closure devices was in descending order scout > scrub > cardiologist. Scrub nurse dose was found to be higher than the cardiologist during closure devices (0.98/0.26 μSv) and diagnostic coronary angiograms (1.51/0.82 μSv). Nursing staff should be aware that their levels of radiation dose during some cardiac procedures may come close to or even exceed that of the cardiologist.

摘要

本研究旨在探讨剂量减少软件(ClarityIQ)在透视引导下心导管术期间对患者和医护人员剂量的影响。在未使用剂量减少软件的房间(n=157)中收集剂量测量值,并与使用软件的两个房间(n=1141)中的类似程序进行比较。程序包括诊断性冠状动脉造影、经皮冠状动脉介入治疗、心脏封堵装置(用于封堵房间隔缺损、卵圆孔未闭和心耳)的部署以及永久性起搏器的插入。研究发现,剂量减少软件可有效降低患者和医护人员的剂量约 50%。本研究增加了有限的关于剂量减少软件降低心脏封堵装置植入过程中辐射暴露的文献报告,并证明了剂量减少对心脏病专家和护理人员的剂量的降低。管理人员应确保及时升级血管造影设备,以保护患者和医护人员免受辐射暴露的潜在不良影响。无论是否使用剂量减少软件,在封堵装置期间,平均职业剂量的顺序为透视>洗手>心脏病专家。在封堵装置(0.98/0.26μSv)和诊断性冠状动脉造影(1.51/0.82μSv)期间,洗手护士的剂量均高于心脏病专家。护理人员应该意识到,在某些心脏手术期间,他们的辐射剂量可能接近甚至超过心脏病专家的剂量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fcc/9239962/b9033832e209/13246_2022_1126_Fig1_HTML.jpg

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