Harris Andrew, Loomis John, Hopkins Marilyn, Bylund Jason
University of Kentucky Medical Center, Lexington, Kentucky.
Urol Pract. 2019 Mar;6(2):140-145. doi: 10.1016/j.urpr.2018.05.002. Epub 2018 May 11.
Urologists are increasingly exposed to fluoroscopy as minimally invasive techniques continue to proliferate. Fluoroscopy, or electromagnetic radiation, can cause cellular damage. Appropriate knowledge of safety precautions for fluoroscopy are necessary and ideally should be taught to physicians in training.
A 20-question survey was created to assess radiation safety training, knowledge, behavior and attitudes. The survey was sent via REDCap™ to house staff routinely involved in fluoroscopic cases, including urology, orthopedic surgery, neurosurgery, radiology, general surgery, anesthesia, plastic surgery, cardiology, vascular surgery, and gastroenterology residents and fellows.
Of 218 participants 61 (28%) responded during the 3-week study period. Overall 57% reported learning fluoroscopic radiation safety informally, with 28% receiving informal as well as formal education. Concerning directional x-ray travel and exposure only 20% answered correctly. In terms of conditions potentially related to radiation exposure 86% selected infertility, 87% cataracts, 87% leukemia and lymphoma, 59% central nervous system tumors and 71% birth defects. Twenty percent wear lead lined glasses, 23% dosimeters, 92% thyroid shields, 2% lead gloves, 92% lead apron, 48% lead shield and 1.6% nothing. Of the respondents 49% were unsure if the machine was set to continuous or pulse. Ninety-eight percent knew decreasing time and 100% knew wearing protective materials were ways to decrease exposure. However, concerning distance and exposure only 56% answered correctly. The majority of respondents believe radiation safety is important and would like more formal education.
Fluoroscopic radiation safety knowledge is low among house staff routinely exposed to fluoroscopy. Further study and likely increased formal education are warranted.
随着微创技术的不断普及,泌尿外科医生越来越多地接触到荧光镜检查。荧光镜检查,即电磁辐射,会导致细胞损伤。了解荧光镜检查的安全预防措施是必要的,理想情况下应该教授给正在接受培训的医生。
设计了一份包含20个问题的调查问卷,以评估辐射安全培训、知识、行为和态度。该调查问卷通过REDCap™发送给经常参与荧光镜检查病例的住院医生,包括泌尿外科、骨外科、神经外科、放射科、普通外科、麻醉科、整形外科、心脏病学、血管外科以及胃肠病学的住院医生和研究员。
在218名参与者中,61名(28%)在为期3周的研究期间做出了回应。总体而言,57%的人报告说他们是通过非正式途径学习荧光镜辐射安全知识的,28%的人同时接受了非正式和正式教育。关于X射线的传播方向和照射,只有20%的人回答正确。在可能与辐射暴露相关的情况方面,86%的人选择了不育,87%的人选择了白内障,87%的人选择了白血病和淋巴瘤,59%的人选择了中枢神经系统肿瘤,71%的人选择了出生缺陷。20%的人佩戴铅衬眼镜,23%的人佩戴剂量计,92%的人佩戴甲状腺防护装置,2%的人佩戴铅手套,92%的人穿着铅围裙,48%的人使用铅屏蔽,1.6%的人什么都不使用。在受访者中,49%的人不确定机器是设置为连续模式还是脉冲模式。98%的人知道减少照射时间,100%的人知道佩戴防护材料是减少暴露的方法。然而,关于距离和照射,只有56%的人回答正确。大多数受访者认为辐射安全很重要,并希望接受更多的正规教育。
经常接触荧光镜检查的住院医生对荧光镜辐射安全知识的了解程度较低。有必要进行进一步的研究,并可能增加正规教育。