介入超声心动图医师在结构性心脏病干预中辐射防护装置的有效性

F. Magniez (Interne) , N. Piriou (Praticien Hospitalier) , P. Jaafar (Praticien Hospitalier) , P.Y. Tuergon , C. Cueff (Praticien Hospitalier) , M. Bertrand (Praticien Hospitalier) , J.M. Langlard (Praticien Hospitalier) , L. Legloan (Praticien Hospitalier) , L. Ammour (Radiophysicien) , P. Guerin
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引用次数: 0

摘要

介入超声心动图(IE)在不断发展的结构性心脏介入手术中起着至关重要的作用。先前的研究表明,IE暴露比侵入性心脏病专家高5倍。目前没有针对IE的专用和适配的辐射防护装置。正是基于这一观察,南特大学医院介入心脏病学团队与“LemerPax”公司共同设计了一种专门用于保护手术室IE的辐射防护舱(EchoSafe)。本研究的目的是评估该舱在实际生活中的辐射防护性能。方法我们纳入6个月内所有需要经食管超声心动图的手术。这些程序被分为两组(第一组使用通常的保护装置,即含铅玻璃门-第二组使用“Echosafe”装置)。我们匹配程序,以获得由两组之间的DAP(剂量面积积)估计的总辐照量。用分布在全身的10个TLD(热释光探测器)对IE进行辐照测量。结果共纳入64例手术,对照组24例,echosafe组40例。各组累积DAP为75,206.9 Cgy/cm2,对照组为70,042 mGy。回声安全组Cm2。两组患者特征相同。结果显示,在“echosafe”组中,左晶状体、肩部、胸部和颈部的辐照量低于剂量限制,右侧晶状体、右手腕、左手腕、耻骨和右脚踝的辐照量分别减少了49%、76%、12%、49%和36%。结论“echosafe”装置可明显减少结构性心脏介入时IE的辐照。超声仪的辐照测量(图1)。
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Effectiveness of a radiation protective device of interventional echocardiographers during structural heart disease interventions

Introduction

Interventional echocardiographers (IE) have a crucial role in growing structural heart interventional procedures. Previous studies showed a 5 times higher exposure of IE than that of the invasive cardiologist. No dedicated and adapted radiation protection device currently exists for IE. It is from this observation that the interventional cardiology team of the Nantes University Hospital, together with the company “LemerPax”, have designed a radiation protection cabin (EchoSafe) dedicated to the protection of the IE in the operative room. The objective of this study is to evaluate the radioprotective performances of this cabin in real life.

Method

We included during 6 months all procedures that required transesophageal echocardiography. These procedures were divided into two groups (the first on which the usual protection device were used, i.e. a leaded glass door – the second on which the “Echosafe” device was used). We matched the procedures to obtain a total amount of irradiation estimated by the DAP (dose area product) close between the two groups. Irradiation measurements of the IE were performed with 10 TLD (thermoluminescent detectors) distributed over the whole body.

Results

We included a total of 64 procedures: 24 procedures in the control group, and 40 in the “echosafe” group. The cumulative DAP for each group was 75,206.9 Cgy/cm2 in the control group, and 70,042 mGy.cm2 in the echosafe group. Patient characteristics were identical between the two groups. The results show that in the “echosafe” group, irradiation was below the dose limit for the left lens, shoulders, thorax, and neck, a 49% reduction in irradiation of the right lens, 76% of the right wrist, 12% of the left wrist, 49% of the pubis, and 36% of the right ankle.

Conclusion

The “echosafe” device offers a clear reduction in the irradiation of the IE during structural heart intervention. Irradiation measurment of the sonographer (Fig. 1).

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来源期刊
Archives of Cardiovascular Diseases Supplements
Archives of Cardiovascular Diseases Supplements CARDIAC & CARDIOVASCULAR SYSTEMS-
自引率
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发文量
508
期刊介绍: Archives of Cardiovascular Diseases Supplements is the official journal of the French Society of Cardiology. The journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles, editorials, and Images in cardiovascular medicine. The topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Additionally, Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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