[髋关节开放和内固定术中医护人员镜头辐射防护的必要性]。

Nihon Hoshasen Gijutsu Gakkai zasshi Pub Date : 2024-03-20 Epub Date: 2024-01-30 DOI:10.6009/jjrt.2024-1422
Hiroki Matsumoto, Shoya Tokushige, Yasutaka Takei, Yuji Uyama, Masakatsu Mura, Go Hitomi
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引用次数: 0

摘要

在髋关节开放复位内固定术(ORIF)中,由于外科医生的眼睛镜头与病人和 X 射线管距离很近,因此辐射工作者的职业暴露增加是一个主要问题。本研究的目的是明确髋关节开放复位内固定术中放射工作人员的职业辐射量,并研究采取辐射防护措施的必要性。通过使用模型实验绘制空气传播剂量分布图,评估了放射工作人员受到的辐射量。在临床实践中使用了附有小型光刺激发光剂量计的辐射护目镜来测量外科医生接受的镜头剂量,并对辐射护目镜的必要性进行了研究。髋关节置换术中的空气传播剂量分布显示,股骨颈轴向透视比前后向透视的高剂量率区域更广。在股骨颈轴向透视中,外科医生始终处于10 µGy/分钟或更高的高剂量率范围内,护士处于4至10 µGy/分钟的剂量率范围内,放射技师处于0.5 µGy/分钟或更低的剂量率范围内。外科医生每例手术的最大 3 毫米剂量当量为 0.38 毫西弗。与此相反,放射护目镜在 ORIF 中却很有用,因为它能提供约 60% 的屏蔽。建议佩戴防辐射护目镜工作,以避免白内障。
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[The Need for Lens Radiation Protection for Healthcare Provider in Open and Internal Fixation of the Hip Joint].

Increased occupational exposure of radiation workers is a major problem during open reduction and internal fixation (ORIF) of the hip joint, as the surgeon's eye lens is in close proximity to the patient and the X-ray tube. The purposes of this study were to clarify the occupational exposure of radiation workers during ORIF of the hip joint and to examine the need for radiation protection measures. The radiation exposure of radiation workers was evaluated by making an airborne dose distribution map using phantom experiments. The radiation goggles attached with a small optically stimulated luminescence dosimeter were used in clinical practice to measure the lens dose received by the surgeon, and the necessity of radiation goggles was examined. The airborne dose distribution in ORIF of the hip joint showed a wider area of high dose rate during axial fluoroscopy of the femoral neck than during posterior-anterior fluoroscopy. In axial fluoroscopy of the femoral neck, the surgeon was always in the high dose rate range of 10 µGy/min or higher, the nurses were in the dose rate range of 4 to 10 µGy/min, and the radiologic technologists were in the dose rate range of 0.5 µGy/min or lower. The maximum 3 mm dose equivalent to the surgeon per case was 0.38 mSv. In contradiction, radiation goggles were useful in ORIF because they provided approximately 60% shielding. It is advisable to work with radiation goggles to avoid cataracts.

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