凝卷增加皮肤瘤切除术辐射暴露率
Mark D Sawyer1,2, Kayvon Kiani2, Jennifer R Stickel3,4
1Surgical Services/Urology Section, Rocky Mountain Regional VA Medical Center, VA Eastern Colorado Health Care System, Aurora, Colorado, USA.
Journal of endourology
|November 2, 2023
概括
凝卷显著增加了皮肤穿神经切除术 (PCNL) 过程中的辐射暴露. 使用辐射发光定位材料可以帮助限制患者和手术团队的辐射剂量.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 医学物理 医学物理
- 放射学 放射学是一门学科.
背景情况:
- 减少内镜石头手术期间的辐射暴露是一个越来越令人担忧的问题.
- 有相矛盾的证据表明,患者的定位 (倾向于躺着或躺着) 对皮肤穿神经切除术 (PCNL) 期间的辐射剂量的影响.
- 临床观察表明,当患者在凝卷上倾斜时,手术内CT成像的辐射增加.
研究的目的:
- 调查用于皮肤穿神经切除术 (PCNL) 患者定位的凝卷是否直接增加手术内辐射剂量.
- 为了比较与不同定位材料和技术相关的辐射剂量.
主要方法:
- 模拟PCNL位置的人类形状实验使用机器人多平面光镜系统进行.
- 一个光镜幻影被放置在凝卷,毯子上,或直接放在桌子上,并在修改后的仰卧位置.
- 剂量区域产品 (DAP) 在各种定位场景中进行测量和比较,包括C臂方向和液袋使用的影响.
主要成果:
- 在凝卷上放置容易导致测量的DAP显著增加 (146μGy*m2,287%) 与在相同厚度的毯子上放置相比 (62.29μGy*m2,23%).
- 辐射剂量在实验组之间差异很大,即使光镜时间是恒定的.
- 该研究发现,凝卷直接增加辐射剂量,这是以前没有报道的发现.
结论:
- 在PCNL手术中用于患者定位的凝卷显然会增加辐射剂量.
- 外科医生应该考虑使用放射性材料来定位患者,以尽量减少辐射暴露.
- 这一发现对泌尿外科手术中的患者安全和辐射管理有影响.
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