Sanders R, Koval K J, DiPasquale T, Schmelling G, Stenzler S, Ross E
Orthopaedic Trauma Service, Tampa General Hospital, Florida 33601.
J Bone Joint Surg Am. 1993 Mar;75(3):326-30. doi: 10.2106/00004623-199303000-00003.
A prospective study of sixty-five orthopaedic procedures performed with fluoroscopic assistance was undertaken to determine the risk to the primary orthopaedic surgeon with regard to radiation. Radiation was monitored with the use of a universal film badge placed outside the collar of a lead apron, and a gas-sterilized thermoluminescent dosimeter ring worn on each hand. The rings were changed with every operation, but the same film badge was transferred from surgeon to surgeon. The hand dominance of the surgeon, the duration of the operative procedure, the type of operation, and the total time that fluoroscopy had been used were noted. The study was conducted during twenty-one intramedullary nailing procedures (thirteen involving distal locking), forty open reductions with internal fixation (plates and screws), and four external-fixation procedures. All of the badges and rings were submitted for a report regarding radiation exposure. No relationship was found between a ring with a positive reading for exposure to radiation and the duration of the operation. Similarly, there was no correlation between a positive reading and the surgeon's hand dominance. The mean duration of the fluoroscopy was 2.3 minutes for the group for which the rings did not show a positive reading and 4.7 minutes for the group for which the rings did show a positive reading. This was a significant difference (p < 0.0001). There was no positive reading for exposure to radiation from any ring that had been worn during a procedure in which the fluoroscope had been used for less than 1.7 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)
对65例在透视辅助下进行的骨科手术进行了一项前瞻性研究,以确定主刀骨科医生面临的辐射风险。使用置于铅围裙领口外侧的通用胶片徽章以及戴在每只手上的气体灭菌热释光剂量计戒指来监测辐射。戒指每次手术更换,但同一胶片徽章在不同医生之间传递。记录医生的利手、手术持续时间、手术类型以及透视使用的总时长。该研究涵盖21例髓内钉固定手术(其中13例涉及远端锁定)、40例切开复位内固定手术(钢板和螺钉)以及4例外固定手术。所有徽章和戒指都提交了辐射暴露报告。未发现辐射暴露读数为阳性的戒指与手术持续时间之间存在关联。同样,阳性读数与医生的利手之间也没有相关性。戒指读数未显示阳性的组透视平均时长为2.3分钟,戒指读数显示阳性的组为4.7分钟。这是一个显著差异(p < 0.0001)。在透视使用时间少于1.7分钟的手术中佩戴的任何戒指,其辐射暴露读数均未呈阳性。(摘要截短于250字)