介入放射治疗患者所受辐射剂量的单中心调查与分析

摘要

[Objective] To investigate the radiation doses of patients during interventional radiology procedures and explore the preventive measures. [Methods] Radiation dose was measured 1651 times in 947 cases during the interventional operation with area exposure product (AEP) system equipped with DSA (Philip FD20). Perspective time, photography frames, dose-area product (DAP) and entrance surface dose (ESD) were all real time recorded on the DSA. Rank sum test, relevance analysis, and simple linear regression were assessed with statistic analysis. [Results] Mean value of perspective time, photography frames, DAP and ESD were (13.5 ± 12.1) min, (230 ± 180) frames, (194± 192) Gy·cm2, and (0.60 ±0.17) Gy. DAP and ESD were higher in the patient ≥ 50 years old and in the embolization procedures. It was observed that there were linear correlation between DAP and ESD (r = 0.978, P < 0.01). [Conclusion] There was a significant difference in radiation doses in different kinds of procedures, range of patient ages and levels of the performer skills. Total ESD can achieve make more precise prediction of total DAP than use of photography frames or perspective time alone.%[目的]初步调查介入放射治疗的患者术中所受X射线辐射的剂量并探讨降低辐射的方法。[方法]采用DSA机配置的穿透电离室型剂量监测系统(AEP)，实时读取记录947名患者在1651例次介入放射操作中的透视时间、摄影帧数、面积-剂量乘积(DAP)和入射表面剂量(ESD)，运用秩和检验、关联性分析及线性回归分析等统计学方法分析以上数据，比较分析各种不同类型患者、介入操作辐射数据的差异性及相互关系。[结果]患者的透视时间、摄影帧数、DAP、ESD的均值分别为(13.5±12.1)min、(230±180)帧、(194±192)Gy·cm2，(0.60±0.17)Gy，年龄大于50岁的患者、同一部位的所有栓塞操作均有较高的ESD(或DAP)，相关性分析则只有ESD与DAP之间的相关性较好，呈线性正相关(r=0.978,P＜0.01)。[结论]患者的辐射剂量因介入放射操作的类型、患者的年龄及操作者的熟练程度的不同存在着显著差别,使用总ESD比单独摄影帧数和透视时间预测总DAP更加精准。