摘要目的 分析不同类型心血管介入手术患者所受X射线辐射剂量以及影响辐射剂量的因素.方法 按照甲、乙、丙3位术者的患者资料,抽取本院接受心血管介入手术的患者442例,包括单行冠状动脉造影术(CAG)、冠状动脉介入术(PCI)、射频消融术(RFCA)、先天性心脏病介入术(CHD)和永久性心脏起搏器植入术(PCPI).采集患者的皮肤表面累积入射剂量(CD)、剂量面积乘积(DAP)、透视时间.结果 CAG、PCI、RFCA、CHD、PCPI各组患者的CD值分别为(0.34 ±0.23)、(1.33±0.76)、(0.71±0.43)、(0.27±0.22)和(0.92±0.42) Gy,DAP值分别为(34.18±23.33)、( 135.92±81.14)、( 79.79±50.66)、(27.93±23.66)和(94.60±48.11) Gy.cm2.透视时间分别为(4.82±3.73)、(16.64±9.01)、(17.04±15.29)、(9.60±5.97)和(7.31±6.45) min.DAP值与透视时间呈高度相关性(r =0.84,P＜0.05).结论 不同类型心血管介入手术患者所受的平均辐射剂量不同.辐射剂量和透视时间与手术难易度和术者操作熟练程度有关,可通过提高操作技术水平、减少透视时间降低患者辐射剂量.

abstractsObjective To explore the X-ray radiation dose to patients from different cardiovascular interventional procedures and analyze the dose-affecting factors.Methods In accordance with the A,B,C operators,442 patients undergoing cardiovascular interventional procedures were collected,including single coronary angiography (CAG),percutaneous coronary intervention ( PCI ),radiofrequency catheter ablation (RFCA),congenital heart disease intervention (CHD) and permanent cardiac pacemaker implantation (PCPI),to observe dose area product (DAP),cumulative radiation dose (CD),fluoroscopy time.Results CD values of patients in groups of CAG,PCI,RFCA,CHD,PCPI were (0.34 ±0.23),(1.33 ±0.76),(0.71 ±0.43),(0.27 ±0.22) and (0.92±0.42) Gy and DAP values were (34.18 ±23.33),(135.92 ±81.14),(79.79 ±50.66),(27.93 ±23.66),and (94.60 ±48.11 ) Gy·cm2,respectively.Fluoroscopy time were (4.82 ±3.73),( 16.64 ±9.01 ),( 17.04 ± 15.29),(9.60 ±5.97)and (7.31 ±6.45) min.DAP values and fluoroscopy time were highly correlated (r =0.84,P ＜ 0.05 ).Conclusions There is significant difference in radiation dose for cardiovascular interventional procedures.Radiation dose and fluoroscopy time are directly related to surgeons' proficiency in operations.Improvement of operation proficiency should be carried out to reduce the patients' radiation dose.