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儿科介入心脏病学中患者和医生所受的X射线照射——从全球到波兰

Patient and physician exposure to X-rays at pediatric interventional cardiology - from world to Poland.

作者信息

Mirowski Mateusz, Domienik-Andrzejewska Joanna, Moszura Tomasz

机构信息

Nofer Institute of Occupational Medicine, Łódź, Poland (Radiation Protection Department).

Polish Mother's Memorial Research Institute, Łódź, Poland (Department of Pediatric Cardiology).

出版信息

Int J Occup Med Environ Health. 2024 Dec 18;37(6):569-580. doi: 10.13075/ijomeh.1896.02504. Epub 2024 Dec 13.

Abstract

Ionizing radiation is considered as a harmful factor to health. However, X‑rays are widely used in diagnostic and therapeutic procedures such as those performed during cardiac interventions. Their use is particularly invaluable in saving life procedures when the risk of adverse effects of radiation is relatively low compared to the consequences of non-treated or treated with other invasive methods diseases. One branch of these types of medical procedures is interventional cardiology in pediatrics due to possible higher than in adults risks of developing cancer in exposed to ionizing radiation children. On the other hand, medical staff in particular physician, may be exposed to relatively high radiation levels during their work. Parallel with enlarging workload (growing number of procedures per year), high levels of cumulative doses to most exposed, and often not protected, parts of operator's body as eye lenses and brain may be achieved. Exposure to X‑rays in pediatric interventional cardiology is a worldwide point of scientific interest from around 65 years, however assessment and simulating low level doses is still developing. In this review found data presents various trials of evaluating doses or levels of exposure to both medical staff and patient as well as methods of optimization and protection against X‑rays in pediatric cardiac interventional procedures. The issue of establishing diagnostic reference levels was also taken into consideration during analysis. Thirty papers from period 2013 to 2023 were analyzed. The main assumption of this condensed review is to reveal radiation protection methods worldwide and in Poland. Int J Occup Med Environ Health. 2024;37(6):569-80.

摘要

电离辐射被认为是一种对健康有害的因素。然而,X射线广泛应用于诊断和治疗程序,如心脏介入手术中所进行的那些操作。在挽救生命的程序中,当与未治疗或采用其他侵入性方法治疗的疾病后果相比,辐射产生不良反应的风险相对较低时,X射线的使用就显得尤为重要。由于暴露于电离辐射的儿童患癌症的风险可能高于成人,这类医疗程序的一个分支是儿科介入心脏病学。另一方面,医务人员尤其是医生,在工作过程中可能会受到相对较高水平的辐射。随着工作量的增加(每年手术数量的增长),操作人员身体中最易暴露且通常未得到防护的部位,如晶状体和大脑,可能会累积达到高水平的剂量。大约65年来,儿科介入心脏病学中的X射线暴露一直是全球科学界关注的焦点,然而对低剂量的评估和模拟仍在发展中。在本综述中,所发现的数据展示了评估医务人员和患者的剂量或暴露水平的各种试验,以及儿科心脏介入手术中优化和防护X射线的方法。在分析过程中还考虑了建立诊断参考水平的问题。分析了2013年至2023年期间的30篇论文。本简要综述的主要假设是揭示全球及波兰的辐射防护方法。《国际职业医学与环境卫生杂志》。2024年;37(6):569 - 580。

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