摘要
目的对冠状动脉血管造影(CA)患者所受皮肤剂量峰值(PSD)进行测量。方法选取上海市一家三级医院进行病例监测,采用热释光剂量元件和Gaf Chromic XR-RV3胶片两种方法进行患者术中皮肤剂量峰值监测。术中将热释光剂量元件或胶片固定布放在患者身下的诊视床上。记录手术过程k V、m A、曝光时间、介入参考点累积剂量(CD)、剂量面积乘积(DAP)等信息。术后收集样本分别使用热释光剂量测量系统和胶片分析软件进行结果测量和分析。对相关变量进行多元线性回归分析。结果共监测51例CA手术患者剂量,曝光时间最长23.5 min,介入参考点累积剂量1059 m Gy,剂量面积乘积22.9 Gy·cm2,胶片法监测PSD 1.23 Gy,TLD法监测PSD 0.51 Gy。两种方法PSD均与DAP相关(R2分别为0.861,0.777,P均<0.01),胶片法和热释光测量法剂量有显著差异(P<0.01)。结论冠状动脉血管造影存在一定程度的皮肤损伤,热释光剂量测量会低估实际受照剂量,应结合其他辅助方法监测术中患者皮肤剂量,促进临床为患者提供更为安全恰当的治疗方式。
Objective To measure the peak skin dose（PSD） of patients received coronary angiography（CA）. Methods Thermoluminescence dose（TLD） and Gaf Chromic XR-RV3 film were used to monitor the intraoperative peak skin dose. thermoluminescence dose or film were fixed under the table. The k V, m A, exposure time, cumulative dose（CD） and dose-area product（DAP） of the interventional procedure were recorded. Samples were collected postoperatively and the results were measured and analyzed using a thermoluminescence dose measurement system and film analysis software. Multiple linear regression analysis was performed on the relevant variables. Results A total of 51 patients undergoing CA surgery were monitored. The longest exposure time was 23.5 minutes. The cumulative dose at the interventional reference point was 1059 m Gy. The dose area product was 22.9 Gy·cm2. The PSD monitored by the film method was 1.23 Gy, and the PSD monitored by the TLD method was 0.51 Gy. The PSD of both methods was related to DAP（R2=0.861, 0.777, P〈0.01）, and there was a significant difference between the film method and thermoluminescence dose（P〈0.01）. Conclusions Coronary artery angiography has a certain degree of skin damage. Thermoluminescence dose measurement underestimates the actual exposure dose. It should be combined with other auxiliary methods to monitor the skin dose of the patient, and promote the clinical to provide patients with a safer and more appropriate treatment.
作者
王彬
高林峰
钱爱君
姚杰
肖虹
蒋舟
Wang Bin, Gao Linfeng, Qian Aijun, Yao fie, Xiao Hong, Jiang Zhou.(Shanghai Municipal Center for Disease Control ＆ Prevention, Shanghai 200336, China)
出处
《中国循证心血管医学杂志》
2018年第5期601-603,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
