Chen M Y, Van Swearingen F L, Mitchell R, Ott D J
Department of Radiology, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27157-1088, USA.
Gastrointest Endosc. 1996 Jan;43(1):1-5. doi: 10.1016/s0016-5107(96)70250-x.
To measure the radiation exposure to endoscopists, patients, and assistants during diagnostic and therapeutic ERCP and to assess the effect of a protective lead shield. Radiation dose with and without the protective lead shield was mapped in our standard fluoroscopy room.
Twenty patients undergoing ERCP were selected for this study. Radiation exposure of endoscopists with and without a protective shield was monitored by digital dosimeter. Radiation exposure for diagnostic procedures was correlated with that of therapeutic procedures.
Endoscopists were exposed to 2.5 mR without the protective shield, but exposure was reduced to an average of 0.27 mR per procedure with the shield. Endoscopists received an average of 1.5 mR per diagnostic ERCP and 3.17 mR per therapeutic ERCP without the shield. When using the protective shield, however, those numbers were reduced to an average of 0.25 mR per diagnostic procedure and 0.28 mR per therapeutic procedure. Radiation exposure to endoscopic assistants, who were not shielded, averaged 0.56 mR per procedure.
Amount of radiation exposure to occupational personnel during ERCP was related to duration of fluoroscopy and type of procedure. Radiation exposure to endoscopists can be significantly reduced by the use of a protective shield. Medical assistants received less radiation than did endoscopists because the assistant's position was more distant from x-ray sources.
测量诊断性和治疗性内镜逆行胰胆管造影（ERCP）过程中内镜医师、患者及助手所接受的辐射剂量，并评估铅防护屏的防护效果。在我们的标准透视室中绘制了使用和不使用铅防护屏时的辐射剂量图。
本研究选取了20例行ERCP的患者。使用数字剂量仪监测有和没有防护屏时内镜医师的辐射暴露情况。将诊断性操作的辐射暴露与治疗性操作的辐射暴露进行关联分析。
不使用防护屏时，内镜医师的辐射暴露量为2.5毫伦琴（mR），但使用防护屏后，每次操作的暴露量平均降至0.27 mR。不使用防护屏时，内镜医师在每次诊断性ERCP中的平均辐射暴露量为1.5 mR，在每次治疗性ERCP中的平均辐射暴露量为3.17 mR。然而，使用防护屏时，这些数字分别降至每次诊断性操作平均0.25 mR和每次治疗性操作平均0.28 mR。未受防护的内镜助手每次操作的平均辐射暴露量为0.56 mR。
ERCP过程中职业人员的辐射暴露量与透视时间和操作类型有关。使用铅防护屏可显著降低内镜医师的辐射暴露。医疗助手接受的辐射比内镜医师少，因为助手的位置离X射线源更远。
