桡动脉入路经皮冠状动脉介入治疗患者头部和性腺的辐射防护Patient head and gonad protection from radiation in trans-radial percutaneous coronary interventions
钱海,朱鸣,胡德兴,岑泽民,楼钶楠,章璐幸
摘要(Abstract)：
目的评估经桡动脉入路经皮冠状动脉介入治疗(PCI)术中患者头部和性腺的辐射剂量,并评价物理辐射防护的效果。方法采用仿真人体模型代替患者,采集经桡动脉入路PCI术中模拟患者头部和性腺在物理辐射防护前后的体表入射剂量率,采用配对t检验和单因素方差分析进行统计分析并计算射线屏蔽率。结果模拟患者头部和性腺在有防护时的体表入射剂量率显著低于无防护时,差异均有统计学意义(头部:t=243.541～738.728,性腺:t=277.934～901.467,均P<0.001)。无论有无防护,在相同造影体位下头部和性腺的体表入射剂量率差异均有统计学意义(无防护:t=4.704～172.484,有防护:t=38.281～181.942,均P<0.001)。无防护时,头部各造影体位之间体表入射剂量率差异有统计学意义(F=3835.427,P<0.001);性腺各造影体位之间体表入射剂量率差异有统计学意义(F=4572.454,P<0.001)。有防护时,头部各造影体位之间体表入射剂量率差异有统计学意义(F=4269.812,P<0.001);性腺各造影体位之间体表入射剂量率差异有统计学意义(F=8107.038,P<0.001)。有防护时模拟患者头部射线屏蔽率为65.85%(左足位)～85.60%(正头位),性腺射线屏蔽率为54.53%(左头位)～79.00%(右侧位)。在正足位、左足位和右足位,头部射线屏蔽率低于性腺,其余5个体位,头部射线屏蔽率均高于性腺。结论在经桡动脉入路PCI术中,无防护时患者头部和性腺受到较高剂量的辐射,辐射强度与造影体位有关,使用物理辐射防护可以大大降低辐射剂量。
关键词(KeyWords)： 经皮冠状动脉介入治疗;体表入射剂量率;头部;性腺;辐射防护
基金项目(Foundation):
作者(Author): 钱海,朱鸣,胡德兴,岑泽民,楼钶楠,章璐幸
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