摘要
目的:使用蒙特卡洛方法和三维体素人体模型研究医生在肝动脉化疗栓塞手术中不同站姿下的眼晶状体辐射剂量水平,并比较铅面罩和铅眼镜对于眼晶状体的辐射防护效果。方法:以介入医护人员为研究对象,并选取面对病人、左转45°、右转45°3种常用站姿,计算佩戴铅面罩、佩戴铅眼镜、眼睛无防护措施3种情况下,医生的眼晶状体年当量剂量和左右眼晶状体的吸收剂量。结果:无防护情况下,眼晶状体受到年当量剂量按照左转45°、面对病人和右转45°这3种情况依次减小,但均超过IBSS年剂量限值20 mSv。戴铅眼镜情况下,不同站姿眼晶体年当量剂量相似且接近IBSS年剂量限值。戴铅面罩情况下,不同站姿下所受剂量均较小。对于左右眼晶体吸收剂量比较,左转45°时,右眼晶体剂量率大于左眼;而其他两种站姿时,右眼均小于左眼晶体剂量。结论:为了减少医生在肝动脉化疗栓塞手术中眼晶状体所受到的辐射剂量,在保证手术质量前提下,若无防护措施,应尽量采用正面面对和右转45°站姿。建议医生手术时佩戴铅面罩,将眼晶状体当量剂量降到最低。如果没有铅面罩,需注意加强左眼晶体的防护。
Objective Transcatheter arterial chemoembolization （TACE） operation is widely used in current interventional radiation therapy, which may create high radiation dose in the eye lens of the operators, leading to the cloudy of the eye lens or even worse, cataract. In the study, the eye lens doses and differences for a doctor who was in different postures and used different eye protection wears during TACE were analyzed by using Monte Carlo method and 3D voxel phantom. Methods The annual equivalent doses and the absorbed doses of the left and right eye lens of the doctor wearing lead glasses, or lead mask, or nothing, each in different standing postures： facing 45° to the left, facing 45° to the right and facing the patient, were simulated and calculated. Results Without any protection, the equivalent doses for the eye lens of the doctor in three different standing postures were all larger than the dose limit 20 mSv, the reference value from International Bibliography of the Social Sciences （1BSS） in 2014, and decreased in the order of facing 45° to the left, facing the patient and facing 45° to the right. With lead glasses, the equivalent doses in different standing postures were close to the dose limit of IBSS; with lead mask, the equivalent doses were smaller. The absorbed doses of different eye lens were different： the doses of the left eye lens were less than those of the right lens for the doctor facing 45° to the left, while the dose results the left lens were greater than those of the right lens for the other two standing postures. Conclusion In order to reduce the eye lens dose without affecting the operation quality, doctors were suggested to wear lead mask, avoid turning left when operating in TACE without eye lens protections, and pay more attention to the left lens protection if lead mask is not available.
出处
《中国医学物理学杂志》
CSCD
2016年第6期553-558,共6页
Chinese Journal of Medical Physics
基金
国家自然科学基金(11375181
11375182)
关键词
肝动脉化疗栓塞
介入放射学
体素模型
蒙特卡洛
辐射剂量
眼晶状体
铅眼镜
铅面罩
transcatheter arterial chemoembolization
interventional radiology
voxel model
Monte Carlo
radiation dose
eye lens
lead glasses
lead mask
