【摘要】：目的探討野戰(zhàn)綜合手術(shù)救治方艙內(nèi)施行冠狀動(dòng)脈(冠脈)造影中不同的投照體位對(duì)患者輻射劑量和影像質(zhì)量的影響,為劑量?jī)?yōu)化提出建議。方法用標(biāo)準(zhǔn)體模測(cè)定冠脈造影9個(gè)不同投照體位下圖像清晰時(shí)劑量面積乘積(DAP)和入射表面劑量(ESD)透視和攝影的輻射劑量值;并在方艙內(nèi)對(duì)6只實(shí)驗(yàn)動(dòng)物施行9個(gè)不同投照體位下的冠脈造影,觀察比較不同體位的影像質(zhì)量。結(jié)果不同投照體位下,透視時(shí)DAP劑量范圍值為12.96～31.28μGym2/s,ESD透視范圍為21 403.33～71 106.67μGy/S;攝影時(shí)DAP劑量范圍值為39.55～87.59μGy/s(10幀),ESD劑量范圍值為67 647.25～212 498.54μGy(10幀)。正位劑量值最小,脾位最大,其他體位與正位相比差異均有統(tǒng)計(jì)學(xué)意義(P0.05);不同體位影像質(zhì)量平均評(píng)分值范圍為3.55～3.85,正位影像質(zhì)量最好,脾位最差,其他體位與正位相比差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論不同投照體位,輻射劑量、影像質(zhì)量不同。手術(shù)過(guò)程中應(yīng)根據(jù)手術(shù)需要,合理選擇投照體位以期既能保證圖像質(zhì)量又能減少患者受照劑量。
[Abstract]:Objective to investigate the effects of different positions of coronary angiography (CAG) on the radiation dose and image quality of patients undergoing combined field surgery, and to provide suggestions for dose optimization. Methods the dose area product (DAP), incident surface dose (ESD) fluoroscopy and radiation dose were measured by standard phantom under 9 different positions of coronary angiography. Coronary angiography under 9 different positions was performed in 6 experimental animals in the cubicle to observe and compare the image quality of different postures. Results the dose range of DAP in different positions was 12.96V 31.28 渭 Gym2 / sESD, 21,403.33v / s, 71 渭 Gy / s, and that of DAP was 39.55 渭 Gy/s (10 frames) and 67,647.25212 498.54 渭 Gy (10 frames), respectively. The average image quality of different positions was 3.55 ~ 3.85, the quality of positive image was the best, the spleen position was the worst, the difference was significant (P0.05), the value of positive position was the smallest, the spleen position was the largest (P0.05), and the average image quality of different positions was 3.55 ~ 3.85. There were significant differences between other postures and positive postures (P0.05). Conclusion different position, radiation dose and image quality are different. In order to ensure the image quality and reduce the radiation dose, the position should be reasonably selected according to the need of operation.
【作者單位】： 沈陽(yáng)軍區(qū)總醫(yī)院心血管內(nèi)科;
【基金】：遼寧省科技攻關(guān)課題(2011225006)
【分類號(hào)】：R82

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