防放射线手术操作房对介入术中防护效率与操作灵活性的影响

目的观察在目前铅衣、铅围脖和铅屏组合的基础上加用新型专利装置防放射线手术操作房对射线防护效率与手术操作灵活性的影响。方法在50台冠脉介入手术过程中分别使用铅衣、铅围脖和铅屏组成的传统防护系统和在此基础上附加防放射线手术操作房的新型防护系统,以盖革计数器测量放射当量以评价防护效率的优劣性。铅衣和防护房测量位置均设定为离地面130 cm,相当于身高170 cm术者的胸部位置,铅衣和防护房内外表面各设一测量点。屏蔽效率计算公式为：屏蔽效率=（外部X射线当量-内部X射线当量）/外部X射线当量×100%。术者对使用过程中防护装置对手术的影响和球管调整时的可操作性进行评分。结果新型防护系统在屏蔽效率方面明显超过传统防护系统（99.06%±0.74%比90.33%±1.41%,P〈0.01）,在目前防护基础上进一步降低术者射线曝光量约90%,而在对手术的影响（0比0）和球管调整时的可操作性（2.96±0.20比3.00±0）方面两者差异无统计学意义（P〉0.05）。结论在目前铅衣、铅围脖和铅屏组成的传统防护系统基础上附加防放射线手术操作房的防护效果是传统防护装置的10倍,且对手术无不良影响,球管调整时操作灵活,是放射防护装置的发展方向。

Objective To observe the effect of additional use of anti-radiation operating room on the basis of employing traditional protection devices on the radiation protection efficiency and handle flexibility of operators working in interventional procedures.Methods The traditional anti-radiation system,including lead rubber apron,bib and hanging screen,and a new anti-radiation system were employed in 50 coronary intervention procedures.The radiation protection efficiency was evaluated by using a Geiger counter.The measuring distance for lead rubber apron and protection shield was 130 cm height from the floor,corresponding to the chest level of a 170-centimeter tall operator.At this level one point was set up on both the inner and outer surface of the protective devices.The radiation shielding effectiveness was calculated by using the following formula： shielding efficiency =（outer X-ray dose-inner X-ray dose） ÷ outer X-ray dose × 100%.And the influence of the protective devices on the surgery and handle flexibility was evaluated by the operator with scores.The results were analyzed.Results The shielding efficiency of the new anti-radiation system was 99.06% ± 0.74%,which was obviously better than that of traditional anti-radiation system（90.33% ± 1.41%）,the difference was statistically significant（P 0.01）.No significant difference in hampering to operation（0 vs 0,P 0.05） and handle flexibility during adjusting tube-direction（2.96 ± 0.20 vs 3.00 ± 0,P 0.05） existed between the two systems.Conclusion On the basis of using traditional protection system such as lead rubber apron,bib and hanging screen,additional use of anti-radiation operating room can increase the radiation shielding efficiency,and it will not interfere the operation and handle flexibility during adjusting tube-direction.

介入放射学，辐射防护，X射线防护装置，操作灵活性，interventional radiology，radiation protection，X-ray protection equipment，handle flexibility。

防放射线手术操作房对介入术中防护效率与操作灵活性的影响。