在放射科以外进行的介入性非心脏手术中透视时间的变化

Murdhi A. Al Harbi, A. Malki, S. Ahmari, K. Soliman
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摘要

目的:提高医生对病人暴露于辐射的认识是减少辐射潜在有害影响的重要一步。已发表的研究表明,向医生提供有关其透视时间的反馈可减少平均透视时间。这项工作的目的是分析和公布我们的医疗中心在过去一年中观察到的数据;监测照射时间(FT)、剂量面积积(DAP)和累积剂量(CD)。方法:透视时间是放射安全审计中使用的多重辐射剂量指标之一。如今,这种审计已成为患者护理安全和质量改进的要求;正如国内和国际认证机构所表明的那样。所有由外科医生和介入医生在放射科外进行的非心脏手术均被查看。提取FT、DAP和CD进行分析。结果:共846例(骨科643例,其他99例,泌尿外科73例,胸部17例,血管7例,ERCP 4例)。平均FT为1.3分钟,平均CD为12.98 mGy,平均DAP为4.53 Gy/cm2。最长FT为55 min,最大CD为904 mGy,最大DAP为689 Gy/cm2。通过spearman相关检验发现,FT与DAP存在显著相关(相关系数= 0.615,p值< 0.001)。FT与CD有显著相关(相关系数= 0.628,p值< 0.001)。结论:每个手术中使用的FT信息可作为患者剂量优化的工具。我们发现DAP和CD之间存在显著的相关性。减少透视时间(FT)是一个辐射防护目标,因为它对患者和工作人员都有保护作用。
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Variability in Fluoroscopic Time during Interventional Non-Cardiac Procedures Performed Outside of the Radiology Department
Purpose: Increasing physician awareness of patient exposure to radiation is an important step towards the reduction of potentially harmful effects of radiation. Published studies demonstrated that providing physicians with feedback regarding their fluoroscopy time leads to a reduction in average fluoroscopy times. The aim of this work was to analyze and publish our medical center data observed during the past year; fluoroscopy time (FT), Dose Area Product (DAP) and cumulative dose (CD) were monitored for radiation protection purposes. Methods: Fluoroscopy time is one of multiple radiation dose indices used in radiation safety auditing. Such auditing is nowadays turning into requirement of patient care safety and quality improvement; as indicated by accreditation bodies both nationally and internationally. All non-cardiac procedures performed outside radiology department by surgeons and interventionists are viewed. FT, DAP and CD are extracted for analysis. Results: a total of 846 cases were studied (643 orthopedic, 99 others, 73 urology, 17 chest, 7 vascular and 4 ERCP cases). Mean FT was 1.3 minutes, mean CD to the patient was 12.98 mGy and the mean DAP was 4.53 Gy/cm2. The longest FT noted was 55 min. The maximum CD was 904 mGy and the maximum DAP was 689 Gy/cm2. Using spearman’s correlation test we found out that there is a significant correlation between FT and DAP (correlation coefficient = 0.615, p. value < 0.001). There is a significant correlation between FT and CD (correlation coefficient = 0.628, p. value < 0.001). Conclusion: Information about FT that used in each procedure can be used as a tool for patient dose optimization. As we found a significant correlation between DAP as well as CD. Reducing fluoroscopic time (FT) is a radiation protection goal, since it serves the purpose of protection for both the patient and the workers.
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