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Patient dose considerations in computed tomography examinations 被引量:4
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作者 Ioannis A Tsalafoutas Georgios V Koukourakis 《World Journal of Radiology》 CAS 2010年第7期262-268,共7页
Ionizing radiation is extensively used in medicine and its contribution to both diagnosis and therapy is undisputable.However,the use of ionizing radiation also involves a certain risk since it may cause damage to tis... Ionizing radiation is extensively used in medicine and its contribution to both diagnosis and therapy is undisputable.However,the use of ionizing radiation also involves a certain risk since it may cause damage to tissues and organs and trigger carcinogenesis.Computed tomography(CT) is currently one of the major contributors to the collective population radiation dose both because it is a relatively high dose examination and an increasing number of people are subjected to CT examinations many times during their lifetime.The evolution of CT scanner technology has greatly increased the clinical applications of CT and its availability throughout the world and made it a routine rather than a specialized examination.With the modern multislice CT scanners,fast volume scanning of the whole human body within less than 1 min is now feasible.Two dimensional images of superb quality can be reconstructed in every possible plane with respect to the patient axis(e.g.axial,sagital and coronal).Furthermore,three-dimensional images of all anatomic structures and organs can be produced with only minimal additional effort(e.g.skeleton,tracheobronchial tree,gastrointestinal system and cardiovascular system).All these applications,which are diagnostically valuable,also involve a significant radiation risk.Therefore,all medical professionals involved with CT,either as referring or examining medical doctors must be aware of the risks involved before they decide to prescribe or perform CT examinations.Ultimately,the final decision concerning justification for a prescribed CT examination lies upon the radiologist.In this paper,we summarize the basic information concerning the detrimental effects of ionizing radiation,as well as the CT dosimetry background.Furthermore,after a brief summary of the evolution of CT scanning,the current CT scanner technology and its special features with respect to patient doses are given in detail.Some numerical data is also given in order to comprehend the magnitude of the potential radiation risk involved in comparison with risk from exposure to natural background radiation levels. 展开更多
关键词 COMPUTED TOMOGRAPHY COMPUTED TOMOGRAPHY dose index dose length product patient dose Effective dose SKIN dose Radiation risk
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Variation in patient dose due to differences in calibration and dosimetry protocols
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作者 Wazir Muhammad Asad Ullah +5 位作者 Gulzar Khan Tahir Zeb Khan Tauseef Jamaal Fawad Ullah Matiullah Khan Amjad Hussain 《Nuclear Science and Techniques》 SCIE CAS CSCD 2018年第5期44-49,共6页
For precise and accurate patient dose delivery,the dosimetry system must be calibrated properly according to the recommendations of standard dosimetry protocols such as TG-51 and TRS-398. However, the dosimetry protoc... For precise and accurate patient dose delivery,the dosimetry system must be calibrated properly according to the recommendations of standard dosimetry protocols such as TG-51 and TRS-398. However, the dosimetry protocol followed by a calibration laboratory is usually different from the protocols that are followed by different clinics, which may result in variations in the patient dose.Our prime objective in this study was to investigate the effect of the two protocols on dosimetry measurements.Dose measurements were performed for a Co-60 teletherapy unit and a high-energy Varian linear accelerator with 6 and 15 MV photon and 6, 9, 12, and 15 MeV electron beams, following the recommendations and procedures of the AAPM TG-51 and IAEA TRS-398 dosimetry protocols. The dosimetry systems used for this study were calibrated in a Co-60 radiation beam at the Secondary Standard Dosimetry Laboratory(SSDL) PINSTECH,Pakistan, following the IAEA TRS-398 protocol. The ratio of the measured absorbed doses to water in clinical setting,D_w(TG-51/TRS-398), was 0.999 and 0.997 for 6 and15 MV photon beams,whereas these ratios were 1.013,1.009, 1.003, and 1.000 for 6, 9, 12, and 15 MeV electron beams, respectively. This difference in the absorbed dosesto-water D_w ratio may be attributed mainly due to beam quality(K_Q) and ion recombination correction factor. 展开更多
关键词 Radiation DOSIMETRY DOSIMETRY systems CALIBRATIONS patient dose Absorbed dose-to-water ratio AAPM TG-51 IAEA TRS-398
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Patient dose from radiographic rejects/repeats in radiology centers of Urmia University of Medical Sciences, Iran
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作者 Nasrollah Jabbari Ahad Zeinali Leili Rahmatnezhad 《Health》 2012年第2期94-100,共7页
Medical diagnostic X-rays are the largest manmade source of ionizing radiation received by the members of the general public. The aim of this study was to evaluate the radiographic reject/repeat rate and also to deter... Medical diagnostic X-rays are the largest manmade source of ionizing radiation received by the members of the general public. The aim of this study was to evaluate the radiographic reject/repeat rate and also to determine dose to the patients from radiographic rejects/repeats in radiology centers of Urmia University of Medical Sciences. During a 4 month period the most frequently examinations were chosen in three radiology centers. A form was designed as a reject/repeat analysis form for radiographers to complete each time a film was rejected by radiologists or repeated. The collected data were compiled at the end of each week and entered into a computer for analysis at the end of study. The results of this study showed that highest and lowest repetition rates were for pelvis, 14.01% and upper limb, 4.17%, respectively. The main reasons of repetition of radiographs were due to exposure (54%) and positioning (18%) errors. The average repeat rate in all three hospitals was 7.20%. It was found that human error has important role to repetition of radiographs. It is demonstrated that those patients having repeated radiographs received an average of 3.23 Gy·cm2. Based on the findings of this study it must be remembered that the highest repetition rate was for pelvis. Considering the radiosensitive organs related to pelvis especially in pediatric patients some special considerations must be applied for pelvis examinations. 展开更多
关键词 patient dose RADIOGRAPHY Exposure REPEAT Rate
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Assessment of Dose and Lifetime Risk of Exposure Induced Cancer in Adult Common Computed Tomography Scans in Douala-Cameroon
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作者 Celestin Mpeke Mokubangele Alexandre Ngwa Ebongue +1 位作者 Daniel Bongue Boniface Moifo 《Open Journal of Radiology》 2024年第3期135-146,共12页
Background: Among medical technologies that use ionizing radiation, CT is currently the radio diagnostic technic that can deliver the highest radiation to the Patient compared with other conventional procedures. In de... Background: Among medical technologies that use ionizing radiation, CT is currently the radio diagnostic technic that can deliver the highest radiation to the Patient compared with other conventional procedures. In developing countries, the uses and risks of CT have not been well characterized. Objective: To estimate the lifetime attributable risk (LAR) incidence and mortality for cancer for each procedure for adult’s patients who had Computed Tomography examinations in 10 imaging centers in the city of Douala-Cameroon so as to provide a reference data. Materials and Methods: We conducted a cross-sectional study describing radiation dose associated with the 8 most common types of diagnostic CT studies performed on 1287 consecutive adult patients at 10 Douala radiology department. We estimated lifetime attributable risks of cancer by study type from these measured doses. Estimation of LAR for cancer incidence and mortality was based on the effective dose, patient’s sex and age at exposure using the BIER VII preferred models. Results: Mean effective dose from CT scans examinations varied from: 0.30 and 8.81 mSv. The highest doses were observed for lumbar spine CT (8.81 mSv), followed by abdomen-pelvis procedure (6.46 mSv), chest-abdomen-pelvic CT (6.61 mSv), chest CT (3.90 mSv), cervical Spine CT (3.05 mSv), head CT (1.7 mSv) and lower for sinus CT (0.30 mSv). The LAR values of all cancer from patients’ CT scans obtained vary from 67.13 excess per 100,000 (about 1 in 1489) and 0.45 excess per 100,000 (about 1 in 222,222). All cancer risk was high for lumbar spine CT in women 20 years old (67.13 excess deaths in 100,000 scans) followed by chest-abdomen-pelvic CT (50.36 excess deaths in 100,000 scans) and abdomen-pelvic CT (49.22 excess deaths in 100,000 scans) for the same age group. The LAR of incidence and mortality values were higher from female’s patients than males and higher for younger than older patients. Conclusion: This study was set out to estimate the LAR values associated with adult common CT scans procedures. The data indicates, LAR risks related to induced cancer from CT exposures were estimated to be low. This risk can be relatively significant for younger age group compared to older age group. The LAR values obtained will help to better evaluate radiation exposure risk, before ordering a CT scans examinations. 展开更多
关键词 patient dose CT Scan BEIIR VII Report Cancer Risk Assessment
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Analysis of Application of Mean Glandular Dose and Factors on Which It Depends to Patients Aged 65 to 80
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作者 Kunosic Suad Kunosic Suada +2 位作者 Davorin Samek Halilcevic Amila Kamenjakovic Samir 《Journal of Physical Science and Application》 2013年第6期387-391,共5页
Every year there are new 1,600 cases of breast cancer in Bosnia and Herzegovina. The most effective method for early detection of breast cancer is mammography. To examine risks and benefits of this diagnostic method i... Every year there are new 1,600 cases of breast cancer in Bosnia and Herzegovina. The most effective method for early detection of breast cancer is mammography. To examine risks and benefits of this diagnostic method it is necessary to determine patient doses. Mainly, almost all published data about patient doses refer to two specific age groups: 40-49 and 50-64 years of age. Very little data about patient doses applied during a routine mammography for patients from 65-80 years of age are available. During the conducted research, one calculated doses for the complete mammographic examination of 42 patients from this age group. The calculated patient doses are related to the whole spectrum of technical, physical, clinical and diagnostic parameters which compose a complete mammographic examination. 展开更多
关键词 Breast cancer patient doses routine mammography.
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Study of the External Dose Rate and Retained Body Activity of Patients with Hyperthyroidism Who Are Receiving Ⅰ-131 Therapy 被引量:2
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作者 LIU Yu Lian ZHAO Zhi Xin +4 位作者 HUO Meng Hui YIN Chen TAN Jian ZHANG Wen Yi JIAO Ling 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 2018年第12期913-916,共4页
Hyperthyroidism refers to a clinical state that results from inappropriately hight hyroid hormone levels in the tissues;.Ⅰ-131 therapy plays a critical role and provides a remarkable curative effect in targeting thyr... Hyperthyroidism refers to a clinical state that results from inappropriately hight hyroid hormone levels in the tissues;.Ⅰ-131 therapy plays a critical role and provides a remarkable curative effect in targeting thyroid diseases. Thyroid cells can take up isotope I-131, which emits not only beta rays but also 展开更多
关键词 ACTIVITY Therapy Study of the External dose Rate and Retained Body Activity of patients with Hyperthyroidism Who Are Receiving
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Patient Peak Skin Dose and Dose Area Product from Interventional Cardiology Procedures
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作者 Antar E. Aly Ibrahim M. Duhaini +3 位作者 Samia M. Manaa Sayed M. Tarique Shehim E. Kuniyil Huda M. Al Naemi 《International Journal of Medical Physics, Clinical Engineering and Radiation Oncology》 2015年第1期7-12,共6页
Information about the peak skin dose and Dose Area product (DAP) from percutaneous transluminal coronary angioplasty (PTCA) and coronary angiography (CA) was collected from three catheter application rooms. The range ... Information about the peak skin dose and Dose Area product (DAP) from percutaneous transluminal coronary angioplasty (PTCA) and coronary angiography (CA) was collected from three catheter application rooms. The range of maximum photon energy was 50 - 125 kVp and the fluoroscopy time was 0.6 - 52 seconds. Values of up to 143 Gy·cm2 for DAP and 0.752 mGy for cumulative dose (CD) were found in CA procedures. Otherwise the DAP and CD for PTCA were found to be 143 Gy·cm2 and 2.287 mGy respectively in 3rd Quartile. The relation between the fluoroscopy time and the DAP is also considered. Objectives: The objective of this study is to obtain information about patient peak skin doses (PSD), dose area product (DAP), Fluoroscopy Time (FT) and Cumulative Dose (CD) from PTCA and CA which is the most predominant with respect to high skin doses in addition to other procedures. The aim of this study is also to assess the radiation dose received by patients undergoing interventional radiology procedures, by identifying the procedures that deliver the highest doses. This study is also helpful to establish the reference dose level for adult patients undergoing interventional procedure, and to provide recommendations on how to reduce dose on selected procedures that have been identified to deliver patient dose values near the ICRP (International Commission on Radiological Protection) threshold values. 展开更多
关键词 INTERVENTIONAL RADIOLOGY patient dose FLUOROSCOPY Time PEAK Skin dose
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Gastroduodenal ulcer bleeding in elderly patients on low dose aspirin therapy 被引量:5
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作者 Koh Fukushi Keiichi Tominaga +5 位作者 Kazunori Nagashima Akira Kanamori Naoya Izawa Mimari Kanazawa Takako Sasai Hideyuki Hiraishi 《World Journal of Gastroenterology》 SCIE CAS 2018年第34期3908-3918,共11页
AIM To determine the clinical characteristics of elderly patients of hemorrhagic gastroduodenal ulcer on low-dose aspirin(LDA)therapy.METHODS A total of 1105 patients with hemorrhagic gastroduodenal ulcer treated in o... AIM To determine the clinical characteristics of elderly patients of hemorrhagic gastroduodenal ulcer on low-dose aspirin(LDA)therapy.METHODS A total of 1105 patients with hemorrhagic gastroduodenal ulcer treated in our hospital between January 2000 and March 2016 were grouped by age and drugs used,and these groups were compared in several factors.These groups were compared in terms of length of hospital stay,presence/absence of hemoglobin(Hb)decrease,presence/absence of blood transfusion,Forrest Ⅰ,percentage of Helicobacter pylori infection,presence/absence of underlying disease,and percentage of severe cases.RESULTS The percentage of blood transfusion(62.6%vs 47.7%,P<0.001),Hb decrease(53.8% vs 40.8%,P<0.001),and the length of hospital stay(23.5 d vs 16.7 d,P<0.001)were significantly greater in those on drug therapy.The percentage of blood transfusion(65.3%vs 47.8%,P<0.001),Hb decrease(54.2%vs 42.1%,P<0.001),and length of hospital stay(23.3 d vs 17.5 d,P<0.001)were significantly greater in the elderly.In comparison with the LDA monotherapy group,the percentage of severe cases was significantly higher in the LDA combination therapy group when elderly patients were concerned(16.1%vs34.0%,P=0.030).Meanwhile,among those on LDA monotherapy,there was no significant difference between elderly and non-elderly(16.1%vs 16.0%,P=0.985).CONCLUSION A combination of LDA with antithrombotic drugs or nonsteroidal anti-inflammatory drugs(NSAIDs)contributes to aggravation.And advanced age is not an aggravating factor when LDA monotherapy is used. 展开更多
关键词 HEMORRHAGIC GASTRODUODENAL ULCER Low-dose ASPIRIN ANTITHROMBOTIC drugs Elderly patients Proton pump inhibitor
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Annual Committed Effective Dose from Various Phytotherapeutic Preparations (due to 238U, 232Th, 222Rn and 220Rn) Estimated for Adult Moroccan Patients
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作者 Mohamed Karime Moulay-Ali Misdaq Aziz Bsiss 《Journal of Biosciences and Medicines》 CAS 2022年第11期45-63,共19页
We use a nuclear technique based on the determination of the detection efficiencies of solid state nuclear track detectors CR-39 and LR-115 type II (SSNTDs) for alpha particles emitted from the series of uranium-238 a... We use a nuclear technique based on the determination of the detection efficiencies of solid state nuclear track detectors CR-39 and LR-115 type II (SSNTDs) for alpha particles emitted from the series of uranium-238 and thorium-232 in a phytotherapeutic sample and the measurement of alpha track densities registered on these detectors to assess alpha activities due to uranium-238;thorium-232;radon and thoron in samples of phytotherapeutic preparations consumed by Moroccan adult patients. For modern preparations, the alpha activities due to <sup>238</sup>U, <sup>232</sup>Th and <sup>222</sup>Rn range from 14.27 mBq/kg to 22.02 mBq/kg, from 6.27 mBq/kg to 9.64 mBq/kg and from 14.27 Bq/kg to 22.02 Bq/kg respectively. For classical preparations, the alpha activities due to <sup>238</sup>U, <sup>232</sup>Th and <sup>222</sup>Rn range from 16.73 mBq/kg to 24 mBq/kg, from 7.34 mBq/kg to 10.82 mBq/kg and from 16.73 Bq/kg to 24.72 Bq/kg respectively. A dosimetric model for ingestion has been highlighted to determine committed equivalent dose to different compartments of human gastrointestinal system due to the ingestion of phytotherapeutic preparations by Moroccan adult patients. The maximum overall effective dose due to <sup>238</sup>U, <sup>232</sup>Th, and <sup>222</sup>Rn after the ingestion of the studied phytotherapeutic preparations, was found equal to 38 × 10<sup>-8</sup> S·vy<sup>-1</sup> which is less than the dose limit given by the international commission for radiological protection in it publication 56. 展开更多
关键词 SSNTD Uranium THORIUM Radon and Thoron Concentrations Phytotherapeutic Preparations Committed Equivalent doses patientS
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Relationship between Patient-Dependent Parameters and Radiation Dose Rates Measured around Patients Undergoing PET/CT Imaging Using <sup>18</sup>F-FDG
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作者 Khaled Soliman Saad Al Qahtani Ahmed Alenezi 《International Journal of Medical Physics, Clinical Engineering and Radiation Oncology》 2018年第3期403-413,共11页
Objectives: Patients undergoing 18F-FDG PET/CT imaging are considered external radiation sources. Accurate dose rate estimates are important for conducting realistic risk assessments and performing dose reconstruction... Objectives: Patients undergoing 18F-FDG PET/CT imaging are considered external radiation sources. Accurate dose rate estimates are important for conducting realistic risk assessments and performing dose reconstruction in cases of accidental exposures. The patient radiation self-attenuation factor is assumed to be a function of the patient’s body size metrics, but we can use these metrics to predict the dose rate around the patients with accuracy. The objective of this work was first to measure the patient attenuation factor by performing direct dose rate measurements from patients undergoing PET/CT imaging studies using 18F-FDG. The second objective was to study the possible correlation between the measured dose rate constant per unit activity from the patients and their body size metrics;five metrics were tested in this work. The last objective was to measure the patients’ voiding factor. Methods: We have measured dose rates at one meter from 57 patients and noted the patient’s height (H), weight (W) and calculated patient size metrics namely: Equivalent Cylindrical Diameter (ECD), Equivalent Spherical Diameter (ESD) and the Body Mass Index (BMI). Results: The measured average dose rate was 92.2 ± 14 μSv&middot;h-1&middot;GBq-1 measured at one meter. Therefore, the dose rate constant of 92 μSv&middot;h-1&middot;GBq-1 proposed by the AAPM, TG-108 report is adequate for radiation protection purposes. There was no statistically significant correlation between the dose rate constant per unit activity and the patient body size metrics. We have measured a patient voiding factor of 0.89 ± 0.06 in comparison with 0.85 recommended by the AAPM. Conclusions: The presented data can be used by medical physicist working in nuclear medicine in formulating more accurate risk estimations resulting from radiation exposure from patients undergoing 18F-FDG PET/CT imaging. 展开更多
关键词 FDG MEASURED dose Rate patient VOIDING FACTOR patient Attenuation FACTOR patient Size
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住院患者质子泵抑制剂的使用情况分析
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作者 任智文 王婷 倪小清 《临床合理用药杂志》 2024年第27期36-39,共4页
目的分析近年来四川省医学科学院·四川省人民医院住院患者质子泵抑制剂(PPIs)使用情况,为临床PPIs的合理使用提供参考。方法收集医院住院信息管理系统中2019—2023年住院患者使用PPIs相关数据信息,包含药物名称、规格、剂型、使用... 目的分析近年来四川省医学科学院·四川省人民医院住院患者质子泵抑制剂(PPIs)使用情况,为临床PPIs的合理使用提供参考。方法收集医院住院信息管理系统中2019—2023年住院患者使用PPIs相关数据信息,包含药物名称、规格、剂型、使用数量和金额等;依据世界卫生组织推荐的限定日剂量(DDD)、用药数量和金额、用药频度(DDDs)和限定日费用(DDC)等药物经济学指标,对相关数据进行统计分析。结果医院住院患者PPIs的使用量呈逐年下降趋势,且使用金额及金额占比均呈逐年下降趋势,其中雷贝拉唑(口服)、兰索拉唑(口服)与艾司奥美拉唑(注射)分别占据DDDs和使用金额的前3位。用药金额与用药人数同步性呈逐年变好趋势,B/A值为1.00的品种占比从2019年的0升至2021年的25%,再到2023年的75%。结论医院住院患者PPIs使用基本合理,用量较大的雷贝拉唑(口服)、兰索拉唑(口服)和艾司奥美拉唑(注射)是目前抑酸剂的一线用药。 展开更多
关键词 质子泵抑制剂 限定日剂量 用药频度 住院患者 合理用药
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联合布托啡诺时环泊酚在老年患者无痛胃镜检查中的有效剂量及安全性 被引量:2
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作者 方志勇 仇晓娟 +1 位作者 冯涛 卞清明 《实用临床医药杂志》 CAS 2024年第12期82-85,共4页
目的探讨联合布托啡诺时环泊酚用于老年患者无痛胃镜检查的半数有效剂量(ED_(50))和95%有效剂量(ED_(95))。方法选择择期行胃镜检查的老年患者27例,均给予静脉注射布托啡诺5μg/kg至少30 s,3 min后静脉注射环泊酚至少30 s;当睫毛反射消... 目的探讨联合布托啡诺时环泊酚用于老年患者无痛胃镜检查的半数有效剂量(ED_(50))和95%有效剂量(ED_(95))。方法选择择期行胃镜检查的老年患者27例,均给予静脉注射布托啡诺5μg/kg至少30 s,3 min后静脉注射环泊酚至少30 s;当睫毛反射消失或者警觉/镇静评分(MOAA/S)<1分时进行胃镜检查。环泊酚最初剂量设为0.2 mg/kg,采用改良序贯等差法测定;若胃镜置入发生阳性反应,则下例患者剂量增加1级,反之则剂量减少1级,相邻剂量梯度为0.05 mg/kg。将胃镜置入发生阳性反应定义为:胃镜进入咽喉部时发生呛咳、吞咽或肢体动作。整个研究过程中,若环泊酚剂量调整有7次折返,试验终止。计算复合布托啡诺时环泊酚对无痛胃镜检查的ED_(50)、ED_(95)和相应的95%可信区间(95%CI)。结果复合布托啡诺时,环泊酚对老年患者无痛胃镜检查的ED_(50)为0.253 mg/kg(95%CI:0.219~0.290),ED_(95)为0.328 mg/kg(95%CI:0.290~0.521)。结论复合布托啡诺时,环泊酚用于老年患者无痛胃镜检查ED_(50)为0.253 mg/kg,ED_(95)为0.328 mg/kg。 展开更多
关键词 环泊酚 布托啡诺 老年患者 胃镜 有效剂量 镇静
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不同剂量异烟肼抗结核化疗方案对药物敏感复治肺结核的疗效 被引量:2
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作者 王梦梦 杨开宁 +2 位作者 王占坤 陈秀秀 肖剑 《西北药学杂志》 CAS 2024年第2期216-220,共5页
目的探讨药物敏感复治肺结核患者应用不同剂量异烟肼抗结核化疗方案治疗的效果及安全性。方法选取收治的对药物敏感的复治肺结核患者97例,按照随机抽样的方式将其分为标准组(n=48)和高剂量组(n=49),标准组依据国家统一的常规剂量(异烟肼... 目的探讨药物敏感复治肺结核患者应用不同剂量异烟肼抗结核化疗方案治疗的效果及安全性。方法选取收治的对药物敏感的复治肺结核患者97例,按照随机抽样的方式将其分为标准组(n=48)和高剂量组(n=49),标准组依据国家统一的常规剂量(异烟肼0.3 g·d^(−1))给药,高剂量组根据患者体质量决定用药量,≥70 kg者异烟肼剂量为0.5 g·d^(−1),<70 kg者为0.4 g·d^(−1),疗程为8个月。比较2组患者治疗结束后X线摄影显示肺部病灶吸收情况的变化;痰菌阴转情况;血清细胞因子水平变化[白细胞介素-18(interleukin-18,IL-18)、γ干扰素(interferon-γ,IFN-γ)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-10(interleukin-10,IL-10)]、生活质量[肺癌生活质量评估量表(functional assessment of cancer therapylung,FACT-L)]评分以及不良反应情况。结果高剂量组病灶吸收率为87.76%,明显高于标准组的70.83%(P<0.05);治疗第1个月和第2个月,2组患者痰液转阴率比较差异无统计学意义,治疗第4个月和第8个月高剂量组患者痰菌转阴率显著高于标准组(P<0.05);治疗8个月后,2组患者血清IL-18、IFN-γ、TNF-α及IL-10水平均显著低于治疗前,且高剂量组显著低于标准组(P<0.05);2组患者FACT-L评分均显著高于治疗前,且高剂量组高于标准组(P<0.05);高剂量组不良发应发生率(18.37%)与标准组(16.67%)比较差异无统计学意义。结论对药物敏感复治肺结核采用高剂量异烟肼治疗疗效较好,能有效增强患者肺部病灶吸收,加快空洞闭合,痰液尽早恢复阴性,血清中的炎症因子水平降低,从而提高生活质量,且无明显不良反应。 展开更多
关键词 异烟肼 不同剂量 复治肺结核患者 安全性
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减低剂量阿扎胞苷治疗老年骨髓增生异常综合征的疗效及安全性分析
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作者 张聪 孙财 +2 位作者 汪德珍 刘占为 房婷 《中国实验血液学杂志》 CAS CSCD 北大核心 2024年第4期1160-1164,共5页
目的:分析减低剂量阿扎胞苷治疗老年骨髓增生异常综合征(MDS)的疗效和安全性。方法:选取2018年1月至2022年6月于安徽省淮北矿工总医院血液内科及徐州医科大学附属医院血液内科初次诊断的92例老年MDS患者,并随机分为观察组和对照组(各46... 目的:分析减低剂量阿扎胞苷治疗老年骨髓增生异常综合征(MDS)的疗效和安全性。方法:选取2018年1月至2022年6月于安徽省淮北矿工总医院血液内科及徐州医科大学附属医院血液内科初次诊断的92例老年MDS患者,并随机分为观察组和对照组(各46例患者)。观察组采用减低剂量阿扎胞苷100 mg/d,d1-7,以28 d为1个疗程,共用6个疗程;对照组采用标准剂量阿扎胞苷75 mg/(m^(2)·d),d1-7,以28 d为1个疗程,共用6个疗程。观察两组患者的临床疗效、总生存期及不良事件发生率。结果:两组患者临床资料差异均无统计学意义(P>0.05)。治疗后,两组患者血红蛋白和血小板水平较各组治疗前均显著升高(P<0.05)。观察组和对照组患者之间的白细胞、血红蛋白和血小板水平对比,差异均无显著统计学意义(P>0.05)。观察组完全缓解、部分缓解、血液学缓解、疾病稳定和疾病进展病例数分别为4、10、22、6和4例,总有效率为78.26%;对照组完全缓解、部分缓解、血液学缓解、疾病稳定和疾病进展病例数分别为8、12、18、4和4例,总有效率为82.61%。观察组患者总有效率略低于对照组,但差异无统计学意义(χ^(2)=0.457,P=0.254)。两种治疗方案对是否有输血依赖和低危、中危及高危组患者的疗效无显著性统计学差异(P>0.05)。对照组和观察组达到最佳治疗反应分别需要4个和6个疗程,且两组患者总生存期无显著差别(P>0.05)。观察组出现感染、Ⅲ-Ⅳ°骨髓抑制、胃肠道反应的病例数分别有4、6和2例,不良事件发生率为26.09%;对照组出现感染、Ⅲ-Ⅳ°骨髓抑制、胃肠道反应的病例数分别有6、16和6例,不良事件发生率为60.87%;对照组患者不良事件发生率显著高于观察组,差异具有统计学意义(χ^(2)=7.095,P=0.036)。结论:老年MDS患者化疗耐受性低。减低剂量阿扎胞苷治疗老年MDS患者显示出良好的疗效和安全性。 展开更多
关键词 骨髓增生异常综合征 老年患者 减低剂量 阿扎胞苷
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环泊酚诱导行腹部手术老年患者意识消失的半数有效量评估
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作者 MUHOZA Bertrand-Geoffrey 梁增辉 +3 位作者 谢艳乐 陈书涵 吴有杰 袁静静 《郑州大学学报(医学版)》 CAS 北大核心 2024年第4期488-491,共4页
目的:评估环泊酚诱导行腹部手术老年患者意识消失的半数有效量(ED 50)。方法:选取2023年4至7月在本院择期全凭静脉麻醉下行腹部手术的老年患者,采用Dixon序贯法纳入研究,初始环泊酚诱导剂量为0.3 mg/kg,相邻患者环泊酚诱导剂量梯度差值... 目的:评估环泊酚诱导行腹部手术老年患者意识消失的半数有效量(ED 50)。方法:选取2023年4至7月在本院择期全凭静脉麻醉下行腹部手术的老年患者,采用Dixon序贯法纳入研究,初始环泊酚诱导剂量为0.3 mg/kg,相邻患者环泊酚诱导剂量梯度差值为0.03 mg/kg,如果患者意识消失则下一例患者降低1个梯度,反之则升高1个梯度,待出现7个交叉拐点则终止该研究。采用Probit概率法计算环泊酚ED 50以及95%CI。记录开始给药至给药后3 min内患者的心率(HR)、脉搏氧饱和度(SpO 2)、平均动脉压(MAP)、脑电双谱指数(BIS)、改良警觉镇静评分(MOAA/S),每30 s记录一次数据;记录给药后患者低血压、心动过缓、呼吸抑制、注射痛情况和诱导期间环泊酚总剂量。结果:共纳入26例,年龄65~78岁,BMI 18.0~28.0 kg/m 2,ASA分级Ⅱ~Ⅲ级。环泊酚诱导致老年患者意识消失的ED 50(95%CI)为0.267(0.250~0.284)mg/kg。与麻醉诱导即刻比较,给药后30、60、90、120、150、180 s时的MOAA/S评分、BIS、MAP明显下降(P<0.05),HR无明显变化;患者均未发生注射痛、低血压和需要处理的心动过缓。结论:环泊酚诱导行腹部手术老年患者意识消失的ED 50(95%CI)为0.267(0.250~0.284)mg/kg。 展开更多
关键词 环泊酚 半数有效量 老年患者 序贯法
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瑞马唑仑艾司氯胺酮在老年患者经内镜逆行性胰胆管造影取石中的应用
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作者 孟庆伟 王晓东 +2 位作者 陈明浩 侯佳 于松杨 《河北医学》 CAS 2024年第11期1902-1907,共6页
目的:探讨甲苯磺酸瑞马唑仑联合小剂量艾司氯胺酮在老年患者经内镜逆行性胰胆管造影取石(ERCP)中的安全性及有效性。方法:将行ERCP取石术的老年患者170例,随机分为A组(86例)和B组(84例)。A组采用甲苯磺酸瑞马唑仑联合小剂量艾司氯胺酮... 目的:探讨甲苯磺酸瑞马唑仑联合小剂量艾司氯胺酮在老年患者经内镜逆行性胰胆管造影取石(ERCP)中的安全性及有效性。方法:将行ERCP取石术的老年患者170例,随机分为A组(86例)和B组(84例)。A组采用甲苯磺酸瑞马唑仑联合小剂量艾司氯胺酮静脉麻醉,B组采用丙泊酚联合小剂量舒芬太尼静脉麻醉,比较两组患者麻醉不同时间点[入室(T0)、内镜进入喉咽部即刻(T1)、胆管造影时(T2)、取石时即刻(T3)、手术结束时(T4)、苏醒时(T5)]的生命体征指标,记录MOAA/S评分、不良反应。结果:两组T1~T4各时间点平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、动脉血氧分压(SPO 2)及水平较T0时明显下降(P<0.05),且A组患者T1~T4时MAP、HR、RR、SPO 2水平较B组更高(P<0.05)。A组患者术后麻醉苏醒后VAS评分为(1.73±0.33)分,低于B组的(2.15±0.38)分,MOAA/S评分为(4.03±0.67)分,高于B组的(3.19±0.53)分(t=7.700,9.052,均P<0.05)。A组麻醉苏醒时间及自主呼吸恢复时间为(7.40±2.12)min、(6.53±1.62)min,均早于B组的(11.57±3.26)min及(8.70±2.18)min(t=9.910,7.378,均P<0.05)。A组低血压、心动过缓等发生率均低于B组(P<0.05)。结论:相较于丙泊酚联合小剂量舒芬太尼,采用甲苯磺酸瑞马唑仑联合小剂量艾司氯胺酮在老年患者ERCP中的安全性及有效性更好,可提高苏醒质量,且产生的不良反应相对比较少。 展开更多
关键词 经内镜逆行性胰胆管造影取石 甲苯磺酸瑞马唑仑 小剂量艾司氯胺酮 老年患者 安全性
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外部验证支持下万古霉素群体药物动力学模型外推用于儿童患者模型引导的精准用药
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作者 吕萌 周宇雪 +1 位作者 王丹姝 张胜男 《中国抗生素杂志》 CAS CSCD 北大核心 2024年第9期1051-1056,共6页
目的本研究旨在对前期在皮肤软组织和骨关节感染的儿童患者中建立的万古霉素群体药物动力学模型进行外部验证,从而判断其是否可以外推至其他患者人群,用于指导万古霉素在儿童患者中的个体化应用。方法从医院信息系统中回顾性提取2021年... 目的本研究旨在对前期在皮肤软组织和骨关节感染的儿童患者中建立的万古霉素群体药物动力学模型进行外部验证,从而判断其是否可以外推至其他患者人群,用于指导万古霉素在儿童患者中的个体化应用。方法从医院信息系统中回顾性提取2021年6月—2022年12月入住我院儿童患者的年龄、性别、体重、实验室检查和万古霉素血药浓度等基本信息。将前期建立的儿童患者群体药物动力学模型在Phoenix软件中重建,通过贝叶斯法预测得到每个患者万古霉素的个体预测值,计算个体预测值与观测值的相对预测误差和均方根误差(百分比)等统计量和作图分析,对已建立的万古霉素群体药代动力学模型进行外部验证。结果共342例儿童患者的399个万古霉素稳态血药浓度数据用于最终的外部验证。除新生儿患者外,婴幼儿、儿童及青少年患者万古霉素血药浓度观测值及预测值计算获得平均预测误差和预测误差中位数均在±20%之内,均方根误差(百分比)在30%之内。根据感染类型分层,除新生儿患者外,呼吸系统感染、中枢神经系统感染及其他感染儿童患者万古霉素血药浓度观测值及预测值计算获得平均预测误差和预测误差中位数均在±20%之内,均方根误差(百分比)在30%之内(呼吸系统感染患者为31.1%)。结论前期建立的儿童患者万古霉素群体药物动力学模型可以外推至婴幼儿、儿童及青少年患者中用于模型引导的精准用药,从而指导万古霉素在儿童患者中的个体化应用。 展开更多
关键词 群体药物动力学模型 外推 万古霉素 儿童 模型引导的精准用药
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亚麻醉剂量艾司氯胺酮对老年腹腔镜直肠癌根治术后康复的影响
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作者 杨昌建 韩丽 +4 位作者 赵月 袁晨 杨芬 谢阳 沈军 《局解手术学杂志》 2024年第9期820-824,共5页
目的探讨亚麻醉剂量艾司氯胺酮用于术后镇痛对老年腹腔镜直肠癌根治术患者早期康复的影响。方法纳入拟行腹腔镜直肠癌根治术的老年患者,采用随机数字表法将患者分为AS组(61例,采用艾司氯胺酮静脉自控镇痛)和SF组(60例,采用舒芬太尼静脉... 目的探讨亚麻醉剂量艾司氯胺酮用于术后镇痛对老年腹腔镜直肠癌根治术患者早期康复的影响。方法纳入拟行腹腔镜直肠癌根治术的老年患者,采用随机数字表法将患者分为AS组(61例,采用艾司氯胺酮静脉自控镇痛)和SF组(60例,采用舒芬太尼静脉自控镇痛)。比较2组患者手术时间、术中输液量、尿量、术中出血量、术后补救镇痛、术后48 h内患者静脉自控镇痛(PCIA)按压次数和曲马多用量、术后视觉模拟量表(VAS)评分、术后Ramsay镇静评分、术后首次下床活动时间、术后首次排气时间及术后首次进食时间。记录2组患者不良反应发生情况。术毕即刻、术后24 h和72 h采用ELISA法检测2组患者白细胞介素-6(IL-6)和C反应蛋白(CRP)水平。比较2组患者术后3 d、1周和1个月焦虑、抑郁评分。结果2组患者手术时间、术中输液量、尿量、术中出血量、术后补救镇痛、术后48 h内曲马多用量及术后48 h内PCIA按压次数比较,差异均无统计学意义(P>0.05)。2组患者术毕即刻、术后24 h和72 h IL-6、CRP水平逐渐升高(P<0.05),且AS组患者术后24 h和72 h的IL-6、CRP水平均显著低于SF组(P<0.05)。AS组患者术后首次下床活动时间、术后首次排气时间、术后首次进食时间均早于SF组(P<0.05)。AS组患者恶心、呕吐和头晕发生率显著低于SF组(P<0.05)。AS组患者术后24 h和72 h的IL-6和CRP水平均显著低于SF组(P<0.05)。AS组患者术后3 d和术后1周的焦虑和抑郁评分显著低于SF组(P<0.05)。结论亚麻醉剂量艾司氯胺酮用于术后镇痛可减轻老年腹腔镜直肠癌根治术患者术后短期焦虑和抑郁,缓解术后疼痛和炎症反应,不良反应发生率低,有助于患者早期康复。 展开更多
关键词 亚麻醉剂量 艾司氯胺酮 老年患者 腹腔镜直肠癌根治术 术后镇痛 早期康复
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丙泊酚及不同剂量瑞马唑仑对舒芬太尼抑制老年患者气管插管反应半数有效剂量的影响 被引量:1
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作者 徐海 朱婷婷 周红梅 《中国现代医生》 2024年第8期79-82,92,共5页
目的应用序贯法探讨丙泊酚或不同剂量瑞马唑仑对舒芬太尼抑制老年患者气管插管反应的半数有效剂量(50%effective dose,ED_(50))的影响。方法选择2022年10至12月在气管插管全身麻醉下接受择期手术的老年患者,美国麻醉医师协会(American S... 目的应用序贯法探讨丙泊酚或不同剂量瑞马唑仑对舒芬太尼抑制老年患者气管插管反应的半数有效剂量(50%effective dose,ED_(50))的影响。方法选择2022年10至12月在气管插管全身麻醉下接受择期手术的老年患者,美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级Ⅰ、Ⅱ级,年龄65~80岁,将患者采用随机数字表法分为4组:丙泊酚组(P组,诱导时给予丙泊酚2mg/kg)和瑞马唑仑组(R1、R2、R3组,诱导时分别静脉注射瑞马唑仑0.2、0.3、0.4mg/kg)。麻醉诱导时给予Dixon序贯法设定剂量的舒芬太尼后,静脉注射丙泊酚或相应剂量瑞马唑仑及顺式阿曲库铵0.15mg/kg,待4个成串刺激(train of four,TOF)计数为0时行气管插管。若气管插管反应阳性,则下一例患者舒芬太尼剂量提高1个浓度梯度,否则降低1个浓度梯度,各相邻浓度之间的比为1∶1.1,直至出现7个转折点终止研究。采用Probit回归分析计算舒芬太尼抑制老年患者气管插管反应ED_(50)和95%有效剂量(95%effective dose,ED_(95))以及相应的95%置信区间(confidenceinterval,CI)。记录所有患者低血压、心动过缓、注射痛等不良反应的发生情况。结果本研究共纳入老年患者113例,P、R1、R2、R3组分别24、28、30、31例。丙泊酚2mg/kg或0.2、0.3、0.4mg/kg瑞马唑仑时舒芬太尼抑制老年患者气管插管反应的ED_(50)和ED_(95)及相应95%CI分别为:P组ED_(50)为0.236μg/kg(95%CI:0.218~0.256),ED_(95)为0.266μg/kg(95%CI:0.250~0.398);R1组ED_(50)为0.284μg/kg(95%CI:0.265~0.309),ED_(95)为0.329μg/kg(95%CI:0.306~0.478);R2组ED_(50)为0.239μg/kg(95%CI:0.221~0.260),ED_(95)为0.282μg/kg(95%CI:0.261~0.415);R3组ED_(50)为0.198μg/kg(95%CI:0.182~0.211),ED_(95)为0.231μg/kg(95%CI:0.216~0.303)。与P组相比,R1、R2、R3组低血压、心动过缓、注射痛发生率较低(P<0.05)。R2组舒芬太尼ED_(50)与P组相类似,但低血压、注射痛发生率与P组相比较低。结论随着瑞马唑仑剂量的增加,舒芬太尼抑制老年患者气管插管反应的ED_(50)逐渐降低;在ED_(50)相近的情况下,瑞马唑仑相较于丙泊酚诱导的低血压、心动过缓、注射痛发生率更低,因而在老年患者气管插管全身麻醉中,使用瑞马唑仑诱导更具有优势。 展开更多
关键词 瑞马唑仑 舒芬太尼 老年患者 心血管反应 半数有效剂量
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Assessment of ESAK and ED for Adult’s Patients Examined by Computed Radiography
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作者 Suhaib Alameen Fatima A. A. Badrey +1 位作者 Abdulrahman S. Abdullateef Abdelfatah M. Ahmed 《International Journal of Medical Physics, Clinical Engineering and Radiation Oncology》 2016年第4期281-287,共7页
This study designed to evaluate the entrance surface air kerma (ESAK) to the patient during X-ray examination to the skull antero-posterior (AP), skull Lateral (LAT), chest postero-anterior (PA), Lumber spine AP/LAT a... This study designed to evaluate the entrance surface air kerma (ESAK) to the patient during X-ray examination to the skull antero-posterior (AP), skull Lateral (LAT), chest postero-anterior (PA), Lumber spine AP/LAT and Pelvis AP. Totally, 408 patients were included in this study using computed radiography (CR) in different three hospitals in Khartoum;five X-ray machines were covered. The entrance surface air kerma (ESAK) was calculated for each patient from the exposure parameters using different peak tube voltages. Patient’s data such as (age and weight) and exposure parameters (kVp) and (mAs) were recorded. The result obtained showed that, the entrance surface air kerma ranged from 0.88 to 3.30 mGy for Skull (AP), 0.588 to 1.87 mGy for skull (LAT), 0.03 to 2 mGy for chest PA, 1.50 to 3.40 mGy Lumbar spine AP, 2.60 to 5.15 mGy for Lumbar spine (LAT), and 1.05 to 4.40 mGy for Pelvis. This study provides additional data that can help the regulatory authority to establish reference dose level for diagnostic radiology in Sudan. This study recommends that the CR operator must be used to optimize the patient dose by using the best strategies available for reducing radiation dose. Computed radiography must be used with high level training for medical staff to reduce the dose;each radiology department should implement a patient dose measurement quality assurance programme. Doses to the patients should be regularly monitored and the proposed national DRLs should be taken as guidance for optimization. 展开更多
关键词 ESAK Estimation dose CR patient dose Effective dose
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