冠心病介入诊治中患者的X射线辐射评估
DOI:
作者:
作者单位:

作者简介:

通讯作者:

基金项目:


The Evaluation of X-Ray Radiation for Coronary Heart Disease Patients in Interventional Process
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
    摘要:

    为探讨在对冠心病进行经皮冠状动脉动脉介入诊治过程中患者所受X线辐射的强度。对112例冠心病患者(5 3例冠状动脉左心室造影和5 9例冠状动脉内支架植入治疗)采用随DSA机配置的穿透电离室型剂量监测系统,测得剂量面积乘积和皮肤入射剂量,用Monte Carlo转换系数从剂量面积乘积估算有效剂量。112例患者进行经皮冠状动脉动脉介入诊治过程中的剂量面积乘积、皮肤入射剂量和有效剂量均值分别为5 9.1±5 1.5Gycm2 、6 2 6±5 90mGy和8.3±7.2mSv;其中冠状动脉内支架植入治疗过程中的剂量值分别为83.5±5 7.6Gycm2 、92 6±6 5 6mGy和11.7±8.1mSv ,冠状动脉左心室造影过程中的剂量值分别为31.9±2 1.5Gycm2 、2 92±2 18mGy和4 .5±3.0mSv ,两组间各剂量值都有非常显著性差异(P<0 .0 1)。冠状动脉内支架植入治疗组透视剂量对总剂量的贡献(剂量面积乘积为6 1.6 %±12 .9% ,皮肤入射剂量为6 2 .1%±14 .2 % )明显大于冠状动脉左心室造影组(剂量面积乘积为4 7.8%±13.9% ,皮肤入射剂量为4 4 .2 %±16 .1% ) ;而摄影剂量对总剂量的贡献(剂量面积乘积为38.5 %±12 .9% ,皮肤入射剂量为37.5 %±13.6 % )明显小于冠状动脉左心室造影组(剂量面积乘积为5 2 .0 %±13.7% ,皮肤入射剂量为5 8.3%±2 7.9) ,两组间各贡献值的差异都有非常显著性意义(P<0 .0 1)。研究结果提示,冠心病患者在经皮冠状动脉动脉介入诊治过程中受到了一次性大剂量的X线辐射,治疗的辐射量明显高于诊断,单纯造影造影诊断对总剂量的影响以摄影为主,经皮冠状动脉动脉介入治疗对总剂量的影响则以透视为主。

    Abstract:

    Aim To investigate the X-ray radiation of coronary heart disease patients rooted in coronary and left ventrical cinematography (CALVC) and intra-coronary stent implantation (ICSI). Methods 112 CHD cases were analysed, including 53 patients with CALVC, and 59 with ICSI. The radiation dose values,such as DAP (dose-area product) and ESD (enter skin dose) measured by using a dose system equipped in Angiostar-Plus, were obtained. Effect dose (ED) was estimated by Monte-Carlo conversion coefficient from the DAP. Results The dose values of DAP, ESD and ED in this serial measured respectively for 59.1±51.5 Gycm 2, 626±590 mGy, 8.3±7.2 mSv; in ICSI group for 83.5±57.6 Gycm 2, 926±656 mGy, 11.7±8.1 mSv; and in CALVC group was 31.9±21.5 Gycm 2, 292±218 mGy, 4.5±3.0 mSv, respectively. The fluoroscopy in ICSI contributed to total exposure dose (DAP: 61.6%±12.9%, ESD: 62.1%±14.2%) were larger than in CALVC (DAP: 47.8%±13.9%, ESD: 44.2%±16.1%); and the contribution of photography for total radiation dose in CALVC (DAP: 52.0%±13.7%, ESD: 58.3%±27.9%) were obviously preponderate over ICSI group (DAP: 38.5%±12.9%, ESD: 37.5%±13.6%). There were statistical difference of dose between ICSI and CALVC (p<0.01), and so do the dose contribution of fluoroscopy or radiography. Conclusion The CHDs patients got higher radiation exposure during a PCI process, radiation dose of treatment mode was evidently higher than that of diagnostic radiography. The main influence on total dose in CALVC was radiography, while in ICSI was fluoroscopy.

    参考文献
    相似文献
    引证文献
引用本文

陈胜利,黄齐好,朱栋梁,邹蓉珠,陈国东,黄子诚.冠心病介入诊治中患者的X射线辐射评估[J].中国动脉硬化杂志,2004,12(4):441~444.

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
历史
  • 收稿日期:2003-08-19
  • 最后修改日期:2004-06-07
  • 录用日期:
  • 在线发布日期: