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目的调查心血管介入手术中操作者的有效剂量。方法利用热释光方法对某省属三级甲等医院进行的24例冠状动脉血管造影术(CA)或者继续行经皮穿刺腔内冠状动脉成形术(PTCA)或者继续行冠状动脉支架植入术(PICAS)和4例起搏器植入术(PT)的操作者进行了体表剂量测定和有效剂量估算。结果在CA、PTCA、PICAS中平均手术时间为(19.2±6.3)min,操作者平均每次手术的有效剂量为(4.1±0.9)μSv,在没有铅衣防护的条件下,为(52.2±15.5)μSv;而PT平均手术时间为(14.1±4.6)min,操作者平均每次手术的有效剂量为(5.5±1.4)μSv,在没有铅衣防护的条件下,为(220±42)μSv。结论应努力提高操作者的技术水平,缩短荧光照射时间,保证医护人员防护设施的配置,以降低操作者的受照剂量。
Objective To investigate the effective dose of the operator during cardiovascular intervention. Methods Twenty-four patients undergoing coronary angiography (CA) or continuing percutaneous transluminal coronary angioplasty (PTCA) or continuing coronary stent implantation (PICAS) and 4 pacemaker implants (PT) performed body-surface dosimetry and effective dose estimation. Results The average operative time was (19.2 ± 6.3) min in CA, PTCA and PICAS, and the average effective dose of each operation was (4.1 ± 0.9) μSv. In the absence of lead protection, the average operation time was (52.2 ± 15.5) ) μSv. The average operation time of PT was (14.1 ± 4.6) min, and the average effective dose of each operation was (5.5 ± 1.4) μSv. The average operation time was 220 ± 42 μSv without lead protection. Conclusions Efforts should be made to improve the technical level of the operator, shorten the time of fluorescence irradiation, ensure the configuration of protective facilities for medical staff and reduce the dosage of the operator.