摘要
目的:通过对比研究经皮椎体后凸成形术术中不同防护距离对X线辐射防护的影响,以探讨临床工作中适用的辐射防护方式。方法:将45例单节段椎体压缩骨折患者随机分为三组,每组采用不同方式进行辐射防护:A组,术者手术全程处于手术台旁;B组,术者透视时处于手术台旁1.5m(手术室内);C组,术者透视时处于手术台旁4m(手术室外)。三组患者均接受由同一术者进行的PKP手术治疗,记录各组手术时间,并使用PRM-1200辐射仪监测记录术者眼睛、甲状腺、前胸、右手腕的辐射剂量与术前、术后VAS评分及术后并发症情况,进行统计学分析。结果:A、B两组的手术时间与C组手术时间相比,差异均有统计学意义(P<0.05);但A、B两组之间的差异并无统计学意义(P>0.05)。三组的术中辐射时间及骨水泥注射量无明显差异(P>0.05)。3组的手术前及手术后VAS评分对比均无显著差异(P>0.05)。通过配对t检验分析得出,与手术前相比,各组患者的手术后VAS评分均有显著降低(P<0.05)。A组术者眼睛、甲状腺、前胸、右手腕的辐射剂量分别为0.362±0.087mSv,0.435±0.064mSv,0.494±0.106mSv,1.542±0.179mSv;B组分别为0.138±0.055mSv,0.156±0.031mSv,0.158±0.075mSv,0.204±0.121mSv;C组分别为0.112±0.039mSv,0.129±0.052mSv,0.120±0.083mSv,0.292±0.046mSv。各部位B、C两组的辐射值与A组相比差异均有统计学意义(P<0.05)。B、C两组相比,各个部位辐射值差异均无统计学意义(P>0.05)。三组手术病例术后均无神经损伤、肺栓塞等术后并发症。结论:PKP术中透视时远离放射源是较好的辐射防护方式;距离放射源1.5m既可以有效地降低辐射量,又不会增加手术时间,是较适用于临床且简便易行的方式。
Objectives： To compare the effects of different distances to radiation resources for radiation protection in percutaneous kyphoplasty, and to find out the appropriate methods for clinical work. Methods： 45 patients admitted for single level osteoporotie vertebral compression fracture were divided into 3 groups randomly（group A, B and C）： primary operator standing next to operating table for entire operation in group A; primary operator standing 1.5 meters and 4 meters from operating table during fluoroscopic time in group B and C respectively. All surgeries were performed by the same surgeon. The time of operation, duration and times of fluoroscopy, pre- and post-operative visual analogue scale（VAS） were recorded. Meanwhile, radiation doses in the sites of operator＇s eyes, thyroid, chest and fight wrist were recorded by 4 unprotected radiometers （PRM-1200） simultaneously. Results： The time of operation in group C was significantly more than that in group A and B（P〈0.05） and there was no statistical difference on operation time between group A and B （P〉0.05）. There was no statistical difference on fluoroscopic time and Volumes of cement among 3 groups（P〉 0.05）. Either the preor the post-operative VAS showed no statistical difference among 3 groups （P〉0.05）. The post-operative VAS in 3 groups decreased significantly compared with pre-operative VAS respectively （P〈 0.05）. In group A, the dose of radiation delivering to the eyes, thyroid, chest and right wrist was 0.362±0.087mSv, 0.435±0.064mSv, 0.494±0.106mSv and 1.542±0.179mSv, respectively. In group B, the radiation dose was 0.138±0.055mSv, 0.156±0.031mSv, 0.158±0.075mSv and 0.204±0.121mSv, respectively. In group C, the radiation dose was 0.112±0.039mSv, 0.129±0.052mSv, 0.120±0.083mSv and 0.292±0.046mSv, respectively. The radiation doses in eyes, thyroid, chest and right wrist in group A were significantly more than those in group B and C （P〈0.05） and there was no statistical difference on radiation dose between group B and C in all 4 sites （P〉0.05）. No complication such as nerve injury or pulmonary embolism was found in two groups. Conclusions： Distance to radiation resources is a key element for radiation protection and 1.5 meters away from operating table is the best distance to achieve both good radiation protection and curative effect.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
北大核心
2014年第5期417-421,共5页
Chinese Journal of Spine and Spinal Cord
基金
中山大学临床医学研究5010计划项目(编号:2012005)
关键词
辐射防护
距离
放射源
经皮椎体后凸成形术
Radiation protection, Distance, Radiation resources, Percutaneous kyphoplasty
