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目的调查广东省数字X射线摄影(DR)检查中典型成年患者常见投照部位的辐射剂量水平及分布,探讨适用于本省DR的医疗照射指导水平(以下简称“指导水平”)。方法采用分层抽样方法,选取来自广东省2个地级市16家医院的1 220例典型成年患者为调查对象,采用热释光探测器对8个DR投照部位的入射体表剂量(ESD)进行测量,分析ESD及分布,以ESD-积分概率分布曲线第75百分位数剂量修约值作为指导水平建议值。结果患者8个投照部位ESD由高到低依次为腰椎侧位、腰椎前后位、骨盆前后位、胸椎前后位、胸椎侧位、腹部前后位、胸部侧位和胸部后前位(ESD中位数分别为4.55、2.44、2.36、2.26、1.53、1.51、0.45和0.14 m Gy);与其余投照部位ESD比较,胸部后前位最低,腰椎侧位最高(P<0.05);ESD与年龄、电压呈负相关[Spearman相关系数(rS)分别为-0.13、-0.41,P<0.01],与体质量和电量呈正相关(rS分别为0.15和0.46,P<0.01)。三级医院患者胸部后前位、腰椎前后位、腰椎侧位、骨盆前后位、腹部前后位ESD分别低于一级和二级医院(P<0.05)。进口品牌DR 8个投照部位的ESD均低于国产品牌(P<0.01)。典型成年患者DR胸部后前位、胸部侧位、腰椎前后位、腰椎侧位、腹部前后位和骨盆前后位的指导水平建议值分别为0.20、0.80、4.00、9.00、3.00、3.50 m Gy。结论广东省患者DR的ESD低于指导水平,有必要制定适用于本省患者的DR指导水平。
Objective To investigate the radiation dose levels and distribution of common irradiation sites of typical adult patients in digital radiography (DR) examination in Guangdong Province, and to explore the medical radiation guidance level (hereinafter referred to as “guidance level”) applicable to DR in our province. Methods A total of 1 220 typical adult patients from 16 hospitals in two prefecture-level cities in Guangdong Province were selected as stratified sampling method. The dose of surface-in-body dose (ESD) ), ESD and distribution were analyzed, and the 75th percentile dose reduction value of the ESD-integral probability distribution curve was used as a guidance level recommended value. Results The descending order of ESD of the 8 sites for ESD was as follows: lumbar lateral mass, anterior and posterior lumbar vertebrae, anterior and posterior pelvis, anterior and posterior thoracic vertebrae, lateral thoracic vertebrae, anteroposterior abdominal aorta, lateral and posterior thoracic antrum (P <0.05). Compared with the rest of the ESD sites, ESD was significantly associated with age, The voltage was negatively correlated [Spearman’s correlation coefficient (rS) -0.13, -0.41, P <0.01, respectively] and positively correlated with body weight and battery power (rS = 0.15 and 0.46, P <0.01). The anteroposterior posterior position, lumbar anterior and posterior position, lumbar lateral position, anteroposterior pelvis and anteroposterior position in the third grade hospital were lower than those in the first and second level hospitals (P <0.05). The ESD of imported 8 brands of DR was lower than that of domestic brands (P <0.01). Typical adult patients with DR chest anteroposterior position, chest lateral position, lumbar anterior and posterior position, lumbar lateral position, abdominal anteroposterior position and pelvic anteroposterior position guidance level suggested values of 0.20,0.80,4.00,9.00,3.00,3.50 m Gy. Conclusion The ESD of DR patients in Guangdong Province is lower than the level of guidance, so it is necessary to make the DR guidelines applicable to patients in this province.