河北省2016年度X射线诊断医疗照射频度调查
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摘要
目的通过对31家抽样医院的调查,了解X射线诊断照射的分布和应用情况,估算我省X射线诊断医疗照射频度,为做好医疗照射的放射防护工作提供支持。方法采用全国统一的调查表调查,普查诊疗设备数量、放射诊疗类型等信息,采用分层随机抽样原则抽取医院31家,含三级医院5家,二级医院11家,一级医院15家,通过读取医院信息管理系统、人工抄录等方式调查2016年度医疗机构门急诊量、住院人数、常规X射线诊断(含CR和DR)、数字胃肠机、CT诊断等在不同性别和年龄段患者中的应用人次等信息,对结果进行分析,应用线性回归方法估算全省X射线诊断照射应用频度。结果全省配备医用诊断X射线机6 210台,每万人拥有0.76台设备。调查的31家医院中,受检者男女性别比为1∶0.93,40岁以上人群的受照比例最高为52.35%。不同类型X射线检查在相同等级医院应用最多的是胸部摄影,占比19.19%,CT检查占比升高最显著。采用线性回归方程估算全省X射线诊断医疗照射总人次数2 899.87万;应用频度355.17人次/千人口。估计全省不同等级医院同种类型检查的受照人次,二级医院中X射线应用最多,占总应用的66.65%。结论我省X射线设备数量、照射人次、频度均比"九五"期间显著增长,对于我省X射线诊断设备防护工作提出了更高要求。
Objective To study the distribution and application of X-ray diagnosis medical exposure in Hebei province and to estimate the frequency of X-ray diagnostic medical exposure, so as to provide support for the radiological protection of medical exposure through investigating 31 samples of hospital.Methods The information of diagnosis and treatment equipment and the types of radiology were surveyed by a unified questionnaire survey in the whole country. Using stratified random sampling principle, 31 hospitals were selected, including 5 tertiary hospitals, 11 second-class hospitals and 15 first-class hospitals. By reading the hospital information management system, manual copying, the data of emergency outpatient volume, number of hospitalizations, person-times of routine X-ray diagnoses(including CR and DR), digital gastrointestinal machines, CT diagnoses, etc. used in patients of different genders and ages in institutions was investigated in 2016. The results were analyzed and the frequency of X-ray diagnostic irradiation was estimated by linear regression method.Results There were 6 210 diagnostic X-ray machines in the province, with 0.76 equipment per 10 000 people. In the 31 hospitals surveyed, the gender ratio was 1 ∶0.93 and over 40 years old, the highest was 52.35%.Frequency of chest photography was the highest(19.19%) and the increase on CT examination frequency was significant in all types of X-ray diagnostic radiation in the same level hospital. Using the linear regression equation, it was estimated that the total person-times of medical exposure for X-ray diagnosis in the province was 28 998 652, the annual application frequency was 355.17 person-times per thousand people and the frequency of the same type of X-ray radiation was the most in the second level hospitals with proportion of 66.65%.Conclusion The numbers of X-ray equipment, exposure person-times as well as the application frequencies of medical X-ray diagnosis are much higher than that of the "Ninth Five-Year Plan", and the higher requirements for the protection work of the X-ray diagnostic equipment were needed, especially on CT radiation in Hebei Province.
Objective To study the distribution and application of X-ray diagnosis medical exposure in Hebei province and to estimate the frequency of X-ray diagnostic medical exposure, so as to provide support for the radiological protection of medical exposure through investigating 31 samples of hospital.Methods The information of diagnosis and treatment equipment and the types of radiology were surveyed by a unified questionnaire survey in the whole country. Using stratified random sampling principle, 31 hospitals were selected, including 5 tertiary hospitals, 11 second-class hospitals and 15 first-class hospitals. By reading the hospital information management system, manual copying, the data of emergency outpatient volume, number of hospitalizations, person-times of routine X-ray diagnoses(including CR and DR), digital gastrointestinal machines, CT diagnoses, etc. used in patients of different genders and ages in institutions was investigated in 2016. The results were analyzed and the frequency of X-ray diagnostic irradiation was estimated by linear regression method.Results There were 6 210 diagnostic X-ray machines in the province, with 0.76 equipment per 10 000 people. In the 31 hospitals surveyed, the gender ratio was 1 ∶0.93 and over 40 years old, the highest was 52.35%.Frequency of chest photography was the highest(19.19%) and the increase on CT examination frequency was significant in all types of X-ray diagnostic radiation in the same level hospital. Using the linear regression equation, it was estimated that the total person-times of medical exposure for X-ray diagnosis in the province was 28 998 652, the annual application frequency was 355.17 person-times per thousand people and the frequency of the same type of X-ray radiation was the most in the second level hospitals with proportion of 66.65%.Conclusion The numbers of X-ray equipment, exposure person-times as well as the application frequencies of medical X-ray diagnosis are much higher than that of the "Ninth Five-Year Plan", and the higher requirements for the protection work of the X-ray diagnostic equipment were needed, especially on CT radiation in Hebei Province.
引文
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[3] 郑森兴,郭进瑞,张燕,等.2012-2013年福建省医用X射线诊断设备质量控制检测结果分析[J].中国辐射卫生,2014,23(6):522-524.
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[6] 河北省统计局国家统计局河北调查总队.河北省2012年国民经济和社会发展统计公报[N].河北日报,2013-2-27(11).
[7] 张良安.医疗照射研究中的分层抽样方法[J].中华放射医学与防护杂志,1989,9(S1):44-47.
[8] 沈爱国,尹俊清,肖淑娟,等.河北省X射线诊断医疗照射频率与剂量水平[J].中华放射医学与防护杂志,2000,20(S1):45-46.
[9] 郑钧正,贺青华,李述唐,等.我国电离辐射医学应用的基本现状[J].中华放射医学与防护杂志,2000,20(S1):7-14.
[10] 高林峰,郑钧正,卓维海,等.上海市“十一五”期间X射线诊断的应用频率及其分布研究[J].辐射防护,2014,34(5):274-280.
[11] 李朝晖,祖庆,张远浩,等.南平市医疗照射频率调查分析[J].中国辐射卫生,2016,25( 2) :198-200.
[12] 蒙庆春,龙怡蒨,李涛.绵竹市2016年X射线诊断照射频次调查分析[J].中国辐射卫生,2018,27(1):31-33,51.
[13] 杜翔,王进.江苏省2015年度放射诊断医疗照射频度调查与分析[J].中华放射医学与防护杂志,2017,37(10):771-776.
[14] 孙彦玲,卢桂才,李鸿成,等.宁夏地区医疗照射频率水平调查分析[J].中华放射医学与防护杂志,2016,36(10):757-760,779.
[15] 张燕,黄丽华,郑森兴,等.2015年度福建省7家医院医疗照射频度调查结果分析[J].中华放射医学与防护杂志,2017,37(9):705-708.
[16] 苏垠平,卢桂才,肖国兵,等.医院放射诊疗总人次的研究与预测[J].中国辐射卫生,2017,26(3):302-305.
[17] 苑翠红,高林峰,曲良勇,等.基于DICOM文件信息估算多排螺旋CT剂量方法的探讨[J].中华放射医学与防护杂志,2016,36(2):143-148.
[18] 刘泉源,杜海岭,张迪,等.冠状动脉低剂量CT成像的临床应用[J].中国辐射卫生,2014,23(6):517-519.
[2] United Nations Scientific Committee on the Effects of Atomic Radiation.Sources and effects of ionizing radiation,Vol.Ⅰ[R].New York:United Nations,2010.
[3] 郑森兴,郭进瑞,张燕,等.2012-2013年福建省医用X射线诊断设备质量控制检测结果分析[J].中国辐射卫生,2014,23(6):522-524.
[4] United Nations Scientific Committee on the Effects of Atomic Radiation .Sources and effects of ionizing radiation,Vol.Ⅰ:Sources[R].New York:United Nations,2000.
[5] 国家卫生和计划生育委员会.2017中国卫生和计划生育统计年鉴[M].北京:中国协和医科大学出版社,2017.
[6] 河北省统计局国家统计局河北调查总队.河北省2012年国民经济和社会发展统计公报[N].河北日报,2013-2-27(11).
[7] 张良安.医疗照射研究中的分层抽样方法[J].中华放射医学与防护杂志,1989,9(S1):44-47.
[8] 沈爱国,尹俊清,肖淑娟,等.河北省X射线诊断医疗照射频率与剂量水平[J].中华放射医学与防护杂志,2000,20(S1):45-46.
[9] 郑钧正,贺青华,李述唐,等.我国电离辐射医学应用的基本现状[J].中华放射医学与防护杂志,2000,20(S1):7-14.
[10] 高林峰,郑钧正,卓维海,等.上海市“十一五”期间X射线诊断的应用频率及其分布研究[J].辐射防护,2014,34(5):274-280.
[11] 李朝晖,祖庆,张远浩,等.南平市医疗照射频率调查分析[J].中国辐射卫生,2016,25( 2) :198-200.
[12] 蒙庆春,龙怡蒨,李涛.绵竹市2016年X射线诊断照射频次调查分析[J].中国辐射卫生,2018,27(1):31-33,51.
[13] 杜翔,王进.江苏省2015年度放射诊断医疗照射频度调查与分析[J].中华放射医学与防护杂志,2017,37(10):771-776.
[14] 孙彦玲,卢桂才,李鸿成,等.宁夏地区医疗照射频率水平调查分析[J].中华放射医学与防护杂志,2016,36(10):757-760,779.
[15] 张燕,黄丽华,郑森兴,等.2015年度福建省7家医院医疗照射频度调查结果分析[J].中华放射医学与防护杂志,2017,37(9):705-708.
[16] 苏垠平,卢桂才,肖国兵,等.医院放射诊疗总人次的研究与预测[J].中国辐射卫生,2017,26(3):302-305.
[17] 苑翠红,高林峰,曲良勇,等.基于DICOM文件信息估算多排螺旋CT剂量方法的探讨[J].中华放射医学与防护杂志,2016,36(2):143-148.
[18] 刘泉源,杜海岭,张迪,等.冠状动脉低剂量CT成像的临床应用[J].中国辐射卫生,2014,23(6):517-519.