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使用辐射吸收巾减少冠状动脉成形术期间术者的辐射剂量暴露

Reduction in Primary Operator Radiation Dose Exposure During Coronary Angioplasty Using Radiation Absorbing Drape.

作者信息

Sharma Amit B, Agrawal Richa

机构信息

Cardiology, Paras Hospital, Gurugram, IND.

出版信息

Cureus. 2023 Oct 7;15(10):e46619. doi: 10.7759/cureus.46619. eCollection 2023 Oct.

Abstract

Background Percutaneous coronary intervention (PCI) involves the use of ionizing radiation and is a common procedure in a cardiac catheterization suite. The RADPAD® surgical drape (Worldwide Innovations & Technologies, Inc., Lenexa, KS) has been developed to reduce scatter radiation exposure to primary operators during routine PCI procedures. This study aims to assess the efficacy of RADPAD drapes in reducing radiation dose in the catheterization laboratory. Methods This was a single-center, prospective, observational study that aimed to compare the primary operator dose received with and without the use of a commercially available shield (RADPAD) during PCI. A total of 53 consecutive patients undergoing PCI were randomized in a 1:1 pattern to receive either the RADPAD (study group) or no RADPAD (control group). Standard shielding and personal protective equipment were used. Radiation exposure to the primary operator, total fluoroscopy time, number of cine acquisitions, and air kerma were recorded for each procedure. A one-way ANOVA calculator, including the Tukey honestly significant difference (HSD) test, was used to compare the mean values of radiation exposure. Scatterplot analysis and linear regression slopes of dose relative to air kerma were performed. All shields were reused once only. Results The study compared radiation exposure during PCI procedures between patients who received radiation attenuation devices (RADPAD) and those who did not. The RADPAD group had 30 patients, while the NO RADPAD group had 23 patients. There was a significant difference in the number of coronary angiography and single/multi-vessel PCI procedures between the two groups. There was no significant difference in procedural time or air kerma dose between the groups, but the RADPAD group had a significantly lower radiation dose (mean dose of 3.679 mrem) compared to the NO RADPAD group (mean dose of 8.12 mrem) (p < 0.00001). The primary operator dose per unit of air kerma was also significantly lower in the RADPAD group. Overall, the use of RADPAD resulted in a significant reduction in radiation exposure during PCI procedures. Conclusion The present study provides further evidence for the efficacy of using radiation-absorbing drapes (RADPAD) in reducing primary operator radiation dose exposure during coronary angioplasty. The equipment for radiation dose reduction of patients also reduces the radiation dose of medical staff. Therefore, the use of RADPAD is recommended as a safe and effective measure for reducing operator radiation dose exposure during coronary angioplasty.

摘要

背景 经皮冠状动脉介入治疗(PCI)涉及使用电离辐射,是心脏导管室中的常见操作。已开发出RADPAD®手术单(全球创新技术公司,堪萨斯州莱尼克斯),以减少常规PCI手术期间术者受到的散射辐射暴露。本研究旨在评估RADPAD手术单在降低导管室辐射剂量方面的效果。方法 这是一项单中心、前瞻性观察性研究,旨在比较PCI过程中使用市售防护装置(RADPAD)和不使用该装置时术者所接受的剂量。总共53例连续接受PCI的患者按1:1比例随机分组,分别接受RADPAD(研究组)或不接受RADPAD(对照组)。使用标准屏蔽和个人防护设备。记录每个手术过程中术者的辐射暴露、总透视时间、电影采集次数和空气比释动能。使用单因素方差分析计算器(包括Tukey真实显著差异(HSD)检验)比较辐射暴露的平均值。进行散点图分析和剂量相对于空气比释动能的线性回归斜率分析。所有屏蔽仅重复使用一次。结果 本研究比较了接受辐射衰减装置(RADPAD)的患者和未接受该装置的患者在PCI手术期间的辐射暴露情况。RADPAD组有30例患者,无RADPAD组有23例患者。两组之间冠状动脉造影和单支/多支血管PCI手术的数量存在显著差异。两组之间的手术时间或空气比释动能剂量无显著差异,但RADPAD组的辐射剂量(平均剂量为3.679毫雷姆)显著低于无RADPAD组(平均剂量为8.12毫雷姆)(p < 0.00001)。RADPAD组每单位空气比释动能的术者剂量也显著更低。总体而言,使用RADPAD可显著降低PCI手术期间的辐射暴露。结论 本研究为使用辐射吸收手术单(RADPAD)在冠状动脉成形术期间降低术者辐射剂量暴露的效果提供了进一步证据。用于降低患者辐射剂量的设备也降低了医护人员的辐射剂量。因此,建议使用RADPAD作为在冠状动脉成形术期间降低术者辐射剂量暴露的安全有效措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df22/10626564/e983cbb53a61/cureus-0015-00000046619-i01.jpg

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