骨科手术间射线暴露和辐射防护研究进展
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摘要
从辐射的原理、辐射带来的职业风险、骨科手术间术中射线辐射与相关防护措施4个方面进行综述,帮助更多医护人员掌握合理、可行、最低剂量辐射暴露原则,从而为骨科手术辐射安全管理、个人防护提供建议。
引文
[1]张王莹.浅析C型臂X光机在手术室的应用及防护[J].护理研究,2009,23(S1):210-211.
[2]KAPLAN D J,PATEL J N,LIPORACE F A,et al.Intraoperative radiation safety in orthopaedics:a review of the ALARA(As Low As Reasonably Achievable)principle[J].Patient Safety in Surgery,2016,10(1):27.
[3]SAROKI A J,WIJDICKS C,PHILIPPON M J,et al.Orthopaedic surgeons′use and knowledge of ionizing radiation during surgical treatment for femoroacetabular impingement[J].Knee Surg Sports Traumatol Arthrosc,2016,24(12):3962-3970.
[4]HAYDA R A,HSU R Y,DEPASSE J M,et al.Radiation exposure and health risks for orthopaedic surgeons[J].Journal of the American Academy of Orthopaedic Surgeons,2018,26(8):1.
[5]范国鑫,扶青松,顾广飞,等.脊柱微创手术的辐射危害及其防护进展[J].中国脊柱脊髓杂志,2014(3):275-278.
[6]PIERCE D A,PRESTON D L.Radiation-related cancer risks at low doses among atomic bomb survivors[J].Radiat Res,2000,154(2):178-186.
[7]MASTRANGELO G,FEDELI U,FADDA E,et al.Increased cancer risk among surgeons in an orthopaedic hospital[J].Occupational Medicine,2005,55(6):498-500.
[8]DEVALIA K L,GUHA A,DEVADOSS V G.The need to protect the thyroid gland during image intensifier use in orthopaedic procedures[J].Acta Orthopaedica Belgica,2004,70(5):474-477.
[9]The 2007Recommendations of the International Commission on Radiological Protection.ICRP publication 103[J].Ann ICRP,2007,37(2-4):1-332.
[10]KESAVACHANDRAN C N,HAAMANN F,NIENHAUS A.Radiation exposure of eyes,thyroid gland and hands in orthopaedic staff:a systematic review[J].Eur J Med Res,2012,17:28.
[11]AINSBURY E A,BOUFFLER S D,DORR W,et al.Radiation cataractogenesis:a review of recent studies[J].Radiat Res,2009,172(1):1-9.
[12]VANO E,KLEIMAN N J,DURAN A,et al.Radiation cataract risk in interventional cardiology personnel[J].Radiat Res,2010,174(4):490-495.
[13]JACOB S,BOVEDA S,BAR O,et al.Interventional cardiologists and risk of radiation-induced cataract:results of a French multicenter observational study[J].Int J Cardiol,2013,167(5):1843-1847.
[14]RADIOLOGICAL I C O.Protection pregnancy and medical radiation[J].Ann Icrp,2000,30(1):iii.
[15]BLATTERT T R,FILL U A,KUNZ E,et al.Skill dependence of radiation exposure for the orthopaedic surgeon during interlocking nailing of long-bone shaft fractures:a clinical study[J].Arch Orthop Trauma Surg,2004,124(10):659-664.
[16]TSALAFOUTAS I A,TSAPAKI V,KALIAKMANIS A,et al.Estimation of radiation doses to patients and surgeons from various fluoroscopically guided orthopaedic surgeries[J].Radiat Prot Dosimetry,2008,128(1):112-119.
[17]CHERIACHAN D,HUGHES A M,DU MOULIN W S,et al.Ionizing radiation doses detected at the eye level of the primary surgeon during orthopaedic procedures[J].J Orthop Trauma,2016,30(7):e230-e235.
[18]周红菊,邓瑞文,饶忠.X射线对手术室护士心理状态的影响及护理对策[J].护理学杂志,2010,27(20):78-79.
[19]王雅丽,刘素芳.手术室使用C臂机的X线安全防护的现状及对策[J].中华现代护理杂志,2011,17(11):1358-1360.
[20]JINDAL T.The risk of radiation exposure to assisting staff in urological procedures:a literature review[J].Urol Nurs,2013,33(3):136-139;147.
[21]朱卫萍,朱华勇,潘葵芬,等.C形臂X线机对手术室护士辐射剂量和防护措施的探讨[J].现代中西医结合杂志,2007(14):1986-1987.
[22]吴勤,张薏,陈燕,等.C-臂X线机术中应用电离辐射的防护[C].全国第十一届手术室护理学术交流会论文集,南宁:中华护理学会,2007:2.
[23]曾佳兴.C臂X光机在骨科手术中的应用[J].中国临床新医学,2012,5(11):1083-1086.
[24]RAMPERSAUD Y R,FOLEY K T,SHEN A C,et al.Radiation exposure to the spine surgeon during fluoroscopically assisted pedicle screw insertion[J].Spine,2000,25(20):2637-2645.
[25]BAUMGARTNER R,LIBUIT K,REN D,et al.Reduction of radiation exposure from C-arm fluoroscopy during orthopaedic trauma operations with introduction of real-time dosimetry[J].J Orthop Trauma,2016,30(2):e53-e58.
[26]SINGER G.Occupational radiation exposure to the surgeon[J].J Am Acad Orthop Surg,2005,13(1):69-76.
[27]SINGER G,HERRON B,HERRON D.Exposure from the large C-arm versus the mini C-arm using hand/wrist and elbow phantoms[J].J Hand Surg Am,2011,36(4):628-631.
[28]BURNS S,THORNTON R,DAUER L T,et al.Leaded eyeglasses substantially reduce radiation exposure of the surgeon′s eyes during acquisition of typical fluoroscopic views of the hip and pelvis[J].J Bone Joint Surg Am,2013,95(14):1307-1311.
[29]FEIERABEND S,SIEGEL G.Potential infection risk from thyroid radiation protection[J].Journal of Orthopaedic Trauma,2015,29(1):18-20.
[30]张容,赖敏华,冯惠强,等.大型综合医院介入放射防护能力现状及管理对策[J].护士进修杂志,2016,31(19):1757-1759.
[31]HSU R Y,LAREAU C R,KIM J S,et al.The effect of C-arm position on radiation exposure during fixation of pediatric supracondylar fractures of the humerus[J].J Bone Joint Surg Am,2014,96(15):e129.
[32]BUSHBERG J T,SEIBERT J A,LEIDHOLDT E M,et al.The essential physics of medical imaging,third edition[M].Philadelphia,PA:Lippincott Williams &Wilkins,2013:456.
[33]赵雅斐,张鹏,郭伟,等.C形臂X射线机辐射防护状况分析[J].医药论坛杂志,2008(8):41-42.
[34]王少敏.C型臂X射线机在手术应用中的辐射剂量监测结果分析[J].世界最新医学信息文摘,2017(21):112.
[35]张为华,倪卫东,易光兆.C形臂X射线机术中应用的放射防护探讨[J].激光杂志,2011(4):70-71.
[36]周翠玉,王哲慧,孙利萍,等.手术室护士的C形臂X射线辐射及防护探讨[J].中国辐射卫生,2012(4):435-436.
[37]韦丹.脊柱微创手术中医护人员遭受的X线辐射损害及应对措施[J].实用临床医药杂志,2017(4):118-120.
[38]张宏霞.骨科手术室C臂机对医护人员辐射剂量和防护策略研究[D].长春:吉林大学,2010.
[2]KAPLAN D J,PATEL J N,LIPORACE F A,et al.Intraoperative radiation safety in orthopaedics:a review of the ALARA(As Low As Reasonably Achievable)principle[J].Patient Safety in Surgery,2016,10(1):27.
[3]SAROKI A J,WIJDICKS C,PHILIPPON M J,et al.Orthopaedic surgeons′use and knowledge of ionizing radiation during surgical treatment for femoroacetabular impingement[J].Knee Surg Sports Traumatol Arthrosc,2016,24(12):3962-3970.
[4]HAYDA R A,HSU R Y,DEPASSE J M,et al.Radiation exposure and health risks for orthopaedic surgeons[J].Journal of the American Academy of Orthopaedic Surgeons,2018,26(8):1.
[5]范国鑫,扶青松,顾广飞,等.脊柱微创手术的辐射危害及其防护进展[J].中国脊柱脊髓杂志,2014(3):275-278.
[6]PIERCE D A,PRESTON D L.Radiation-related cancer risks at low doses among atomic bomb survivors[J].Radiat Res,2000,154(2):178-186.
[7]MASTRANGELO G,FEDELI U,FADDA E,et al.Increased cancer risk among surgeons in an orthopaedic hospital[J].Occupational Medicine,2005,55(6):498-500.
[8]DEVALIA K L,GUHA A,DEVADOSS V G.The need to protect the thyroid gland during image intensifier use in orthopaedic procedures[J].Acta Orthopaedica Belgica,2004,70(5):474-477.
[9]The 2007Recommendations of the International Commission on Radiological Protection.ICRP publication 103[J].Ann ICRP,2007,37(2-4):1-332.
[10]KESAVACHANDRAN C N,HAAMANN F,NIENHAUS A.Radiation exposure of eyes,thyroid gland and hands in orthopaedic staff:a systematic review[J].Eur J Med Res,2012,17:28.
[11]AINSBURY E A,BOUFFLER S D,DORR W,et al.Radiation cataractogenesis:a review of recent studies[J].Radiat Res,2009,172(1):1-9.
[12]VANO E,KLEIMAN N J,DURAN A,et al.Radiation cataract risk in interventional cardiology personnel[J].Radiat Res,2010,174(4):490-495.
[13]JACOB S,BOVEDA S,BAR O,et al.Interventional cardiologists and risk of radiation-induced cataract:results of a French multicenter observational study[J].Int J Cardiol,2013,167(5):1843-1847.
[14]RADIOLOGICAL I C O.Protection pregnancy and medical radiation[J].Ann Icrp,2000,30(1):iii.
[15]BLATTERT T R,FILL U A,KUNZ E,et al.Skill dependence of radiation exposure for the orthopaedic surgeon during interlocking nailing of long-bone shaft fractures:a clinical study[J].Arch Orthop Trauma Surg,2004,124(10):659-664.
[16]TSALAFOUTAS I A,TSAPAKI V,KALIAKMANIS A,et al.Estimation of radiation doses to patients and surgeons from various fluoroscopically guided orthopaedic surgeries[J].Radiat Prot Dosimetry,2008,128(1):112-119.
[17]CHERIACHAN D,HUGHES A M,DU MOULIN W S,et al.Ionizing radiation doses detected at the eye level of the primary surgeon during orthopaedic procedures[J].J Orthop Trauma,2016,30(7):e230-e235.
[18]周红菊,邓瑞文,饶忠.X射线对手术室护士心理状态的影响及护理对策[J].护理学杂志,2010,27(20):78-79.
[19]王雅丽,刘素芳.手术室使用C臂机的X线安全防护的现状及对策[J].中华现代护理杂志,2011,17(11):1358-1360.
[20]JINDAL T.The risk of radiation exposure to assisting staff in urological procedures:a literature review[J].Urol Nurs,2013,33(3):136-139;147.
[21]朱卫萍,朱华勇,潘葵芬,等.C形臂X线机对手术室护士辐射剂量和防护措施的探讨[J].现代中西医结合杂志,2007(14):1986-1987.
[22]吴勤,张薏,陈燕,等.C-臂X线机术中应用电离辐射的防护[C].全国第十一届手术室护理学术交流会论文集,南宁:中华护理学会,2007:2.
[23]曾佳兴.C臂X光机在骨科手术中的应用[J].中国临床新医学,2012,5(11):1083-1086.
[24]RAMPERSAUD Y R,FOLEY K T,SHEN A C,et al.Radiation exposure to the spine surgeon during fluoroscopically assisted pedicle screw insertion[J].Spine,2000,25(20):2637-2645.
[25]BAUMGARTNER R,LIBUIT K,REN D,et al.Reduction of radiation exposure from C-arm fluoroscopy during orthopaedic trauma operations with introduction of real-time dosimetry[J].J Orthop Trauma,2016,30(2):e53-e58.
[26]SINGER G.Occupational radiation exposure to the surgeon[J].J Am Acad Orthop Surg,2005,13(1):69-76.
[27]SINGER G,HERRON B,HERRON D.Exposure from the large C-arm versus the mini C-arm using hand/wrist and elbow phantoms[J].J Hand Surg Am,2011,36(4):628-631.
[28]BURNS S,THORNTON R,DAUER L T,et al.Leaded eyeglasses substantially reduce radiation exposure of the surgeon′s eyes during acquisition of typical fluoroscopic views of the hip and pelvis[J].J Bone Joint Surg Am,2013,95(14):1307-1311.
[29]FEIERABEND S,SIEGEL G.Potential infection risk from thyroid radiation protection[J].Journal of Orthopaedic Trauma,2015,29(1):18-20.
[30]张容,赖敏华,冯惠强,等.大型综合医院介入放射防护能力现状及管理对策[J].护士进修杂志,2016,31(19):1757-1759.
[31]HSU R Y,LAREAU C R,KIM J S,et al.The effect of C-arm position on radiation exposure during fixation of pediatric supracondylar fractures of the humerus[J].J Bone Joint Surg Am,2014,96(15):e129.
[32]BUSHBERG J T,SEIBERT J A,LEIDHOLDT E M,et al.The essential physics of medical imaging,third edition[M].Philadelphia,PA:Lippincott Williams &Wilkins,2013:456.
[33]赵雅斐,张鹏,郭伟,等.C形臂X射线机辐射防护状况分析[J].医药论坛杂志,2008(8):41-42.
[34]王少敏.C型臂X射线机在手术应用中的辐射剂量监测结果分析[J].世界最新医学信息文摘,2017(21):112.
[35]张为华,倪卫东,易光兆.C形臂X射线机术中应用的放射防护探讨[J].激光杂志,2011(4):70-71.
[36]周翠玉,王哲慧,孙利萍,等.手术室护士的C形臂X射线辐射及防护探讨[J].中国辐射卫生,2012(4):435-436.
[37]韦丹.脊柱微创手术中医护人员遭受的X线辐射损害及应对措施[J].实用临床医药杂志,2017(4):118-120.
[38]张宏霞.骨科手术室C臂机对医护人员辐射剂量和防护策略研究[D].长春:吉林大学,2010.