發(fā)布時(shí)間：2018-01-16 15:05

  本文關(guān)鍵詞：DSA冠脈造影對(duì)病人及醫(yī)護(hù)人員輻射劑量的研究　出處：《吉林大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 數(shù)字減影血管造影(DSA) 冠脈造影 熱釋光劑量計(jì)(TLD) 輻射防護(hù)

【摘要】：冠心病是目前致死率最高的疾病之一，據(jù)統(tǒng)計(jì)，本病在歐美發(fā)達(dá)國(guó)家比較常見(jiàn)，美國(guó)約有700萬(wàn)人患有冠心病，而每年約有50萬(wàn)人死于該病，占人口死亡數(shù)的1/3~1/2，占心臟病死亡數(shù)的50%~75%，我國(guó)雖然不如歐美多見(jiàn)，但近年來(lái)也呈快速地增長(zhǎng)趨勢(shì)，是嚴(yán)重危害人們健康的常見(jiàn)病。目前，臨床經(jīng)驗(yàn)已經(jīng)表明，冠狀動(dòng)脈造影（CoronaryAngiography, CA）為經(jīng)典的冠心病檢查方法，因其準(zhǔn)確度較高，被譽(yù)為診斷冠心病的金標(biāo)準(zhǔn)，而DSA冠狀動(dòng)脈造影出現(xiàn)時(shí)間最早，，技術(shù)比較成熟，且可以引導(dǎo)治療，目前，在絕大多數(shù)醫(yī)院都在使用DSA進(jìn)行冠脈造影。同時(shí)，在放射性介入手術(shù)中，冠狀動(dòng)脈介入程序所占比例也是相當(dāng)高的，在1996年，美國(guó)執(zhí)行的放射性介入程序的次數(shù)就超過(guò)了700000，而心源性干預(yù)措施的冠脈程序與其它介入程序相比為700000：30000。 在放射性介入程序過(guò)程中，介入放射工作人員必須長(zhǎng)時(shí)間在X射線下操作，因此，患者和介入放射工作人員都會(huì)受到大量的輻射照射，不僅有可能引發(fā)確定性效應(yīng)，如患者皮膚損傷，術(shù)者眼晶狀體損傷等，同時(shí)還會(huì)增加隨機(jī)性效應(yīng)發(fā)生的概率，如血象發(fā)生改變（白血�。┖湍贻p女性的乳腺癌發(fā)病率等。然而，人們通常為了追求高質(zhì)量的圖像，在很多時(shí)候都使用較高條件的X射線照射，這就增加介入工作人員和患者的輻射劑量，據(jù)調(diào)查，很多介入工作人員的個(gè)人劑量水平已經(jīng)超過(guò)個(gè)人劑量約束值，同時(shí)，根據(jù)文獻(xiàn)報(bào)道，介入過(guò)程中的患者的放射性損傷也時(shí)有發(fā)生，因此，我們必須要高度重視X射線的防護(hù)問(wèn)題，將介入放射工作人員和患者的受照劑量盡可能地降低，并將其限制在合理地可接受的水平，以防止放射性損傷的發(fā)生。 本實(shí)驗(yàn)根據(jù)進(jìn)行冠狀動(dòng)脈造影介入時(shí)的攝影和透視條件，利用仿真人體模型，模擬冠脈造影手術(shù)，對(duì)患者各敏感器官的劑量，介入放射工作人員鉛衣前和鉛衣后皮膚表面的輻射劑量進(jìn)行測(cè)量并分析，目的是在實(shí)行介入手術(shù)過(guò)程中，對(duì)X射線照射是否可以引發(fā)放射性損傷，以及介入手術(shù)過(guò)程中的輻射劑量學(xué)問(wèn)題進(jìn)行分析，為介入工作人員實(shí)行介入手術(shù)時(shí)，在防護(hù)問(wèn)題方面，提供一些指導(dǎo)性的建議。
[Abstract]:The mortality rate of coronary heart disease is one of the highest disease, according to statistics, the disease is more common in developed countries, about 7 million Americans suffer from coronary heart disease, and every year there are about 500 thousand people died of the disease, the number of deaths accounted for 1/3~1/2, heart disease deaths accounted for 50%~75% in China, although more common than in Europe and America, but in recent years also showed a rapid growth trend, is a common disease which is harmful to people's health. At present, clinical experience has shown that coronary angiography for coronary heart disease (CoronaryAngiography, CA) to check the classical methods, because of its high accuracy, is known as the gold standard for the diagnosis of coronary heart disease, coronary angiography and DSA appeared in the earliest time and the technology is relatively mature, and can guide the treatment, at present, in the vast majority of hospitals are using DSA to coronary angiography. At the same time, the radioactive interventional treatment of coronary artery interventional procedures, the proportion is quite high, In 1996, the number of radioactive intervention procedures performed by the United States exceeded 700000, while the coronary intervention procedures of cardiac interventions were compared with other interventional procedures for 700000:30000..
In the process of interventional procedures, interventional radiology staff must be long time under X ray, therefore, patients and interventional radiology staff will be a lot of radiation, not only may lead to deterministic effects, such as patients with skin damage of eye lens damage, but will also increase the probability of occurrence of random the effect of change, such as blood cells (leukemia) and young women, the incidence of breast cancer. However, people usually in order to pursue high quality image, X rays are used in most of the time is high, which increases the radiation dose in staff and patients according to the survey, many involved in the staff level the personal dose has exceeded the individual dose constraint value, at the same time, according to reports, in the process of interventional radiation injury patients have also occurred, therefore, we must attach great importance to X ray The issue of protection is to minimize the exposure dose of the interventional radiology staff and patients and limit it to a reasonable acceptable level, so as to prevent the occurrence of radiation damage.
This experiment was carried out according to the coronary artery angiography and X-ray photography conditions, using the simulation model of the human body, simulation of coronary angiography in patients with surgery, the sensitive organ dose of radiation workers in the lead clothes before and lead clothes after radiation dose on the surface of the skin was measured and analyzed, the purpose is in the process of interventional operation. The X ray can cause radiation damage, radiation dosimetry problems and intervention in the process of analysis, for the intervention staff through surgical intervention, in protection issues, provide some constructive suggestions.

【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R144.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

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2 白光;醫(yī)學(xué)工作者的職業(yè)照射:劑量水平、輻射危害和個(gè)人劑量監(jiān)測(cè)[J];國(guó)外醫(yī)學(xué)(放射醫(yī)學(xué)核醫(yī)學(xué)分冊(cè));2005年04期

本文編號(hào)：1433616