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X线骨盆测量——其应用及可能的辐射风险。

Radiographic pelvimetry--its use and possible radiation risk.

作者信息

Lundh C, Lindmark G, Wilbrand H, Ytterbergh C

出版信息

Ups J Med Sci. 1984;89(2):135-46. doi: 10.3109/03009738409178473.

Abstract

Radiographic pelvimetry is widely used in obstetrics. Every fourth primapara in Sweden is submitted to this radiographic examination. The frequency of the examination in the United States is estimated to a mean of 6% of all deliveries. The use of radiographic pelvimetry is now under intense debate and the missing argument in this discussion is a prospective study of an unselected group of parturients where progress and outcome of labour is referred to known pelvic dimension. Since the value of the method is questioned the frequent use of radiographic pelvimetry is justified only by an almost negligible radiation risk to the mother and her baby. Such a low risk is also an indispensable condition to allow the correct scientific evaluation of radiographic pelvimetry mentioned above. This paper presents the measurement results of absorbed radiation dose with the only radiographic pelvimetry method used in Sweden. The estimated radiation risk of the method, based on these figures, is 1 case of childhood malignancy in 50 000 pelvimetries. This corresponds to 4 years routine use of radiographic pelvimetry in Sweden. The annual incidence of childhood malignancy in Sweden is 220. The maternal risk is estimated to one tenth of the fetal risk.

摘要

X线骨盆测量在产科中广泛应用。瑞典每四位初产妇中就有一位接受这种X线检查。据估计,美国该项检查的频率平均为所有分娩的6%。目前,X线骨盆测量的应用正处于激烈的争论中,而这场讨论中缺失的论据是对一组未经挑选的产妇进行前瞻性研究,将分娩进展和结局与已知的骨盆尺寸相关联。由于该方法的价值受到质疑,X线骨盆测量的频繁使用仅因对母亲及其婴儿的辐射风险几乎可以忽略不计才具有合理性。如此低的风险也是对上述X线骨盆测量进行正确科学评估的不可或缺的条件。本文介绍了瑞典唯一使用的X线骨盆测量方法的吸收辐射剂量测量结果。基于这些数据,该方法估计的辐射风险是每50000次骨盆测量中有1例儿童恶性肿瘤病例。这相当于瑞典X线骨盆测量4年的常规使用量。瑞典儿童恶性肿瘤的年发病率为220例。母亲的风险估计为胎儿风险的十分之一。

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