94例儿童先心病介入手术辐射剂量及影响因素分析

doi:10.13491/j.issn.1004-714X.2023.06.014

中国辐射卫生

2023, Vol. 32

Issue (6): 673-678 DOI: 10.13491/j.issn.1004-714X.2023.06.014

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94例儿童先心病介入手术辐射剂量及影响因素分析

商玉秀¹, 杨显存², 马娅¹, 王小山¹, 陈英民¹

1. 山东省医学科学院放射医学研究所, 山东第一医科大学(山东省医学科学院), 山东济南 250117;
2. 山东第一医科大学(山东省医学科学院)附属省立医院, 山东济南 250021

Analysis of radiation dose and influencing factors during interventional procedures for 94 patients with pediatric congenital heart disease

SHANG Yuxiu¹, YANG Xiancun², MA Ya¹, WANG Xiaoshan¹, CHEN Yingmin¹

1. Institute of Radiation Medicine of Shandong Academy of Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117 China;
2. Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021 China

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摘要目的评估儿童先心病介入手术的辐射剂量，分析差异性和影响辐射剂量的相关因素。方法将94例2021年6月—2022年9月在山东省济南市某三甲医院接受先心病介入手术的患儿，按手术类型分为3组，包括室间隔缺损封堵术组（VSD组）48例、动脉导管未闭封堵术组（PDA组）29例、房间隔缺损封堵术组（ASD组）17例。记录患者基本资料、术后剂量报告，应用SPSS软件进行统计分析。结果 VSD组、PDA组、ASD组的累积剂量（CAK）中位数分别为100.5 mGy、43.7 mGy、12.1 mGy，剂量面积乘积（KAP）中位数分别为3.309 Gy·cm²、1.313 Gy·cm²、0.540 Gy·cm²，KAP·kg^-1中位数分别达到了0.179 Gy·cm²·kg^-1 、0.088 Gy·cm²·kg^-1 、0.031 Gy·cm²·kg^-1，3种介入手术的透视时间、减影图像数（CI)、CAK值、KAP值和KAP·kg^-1差异有统计学意义（P<0.05)，且VSD组的透视时间、CI、CAK值、KAP值、KAP·kg^-1均显著高于PDA组和ASD组（P<0.05）。多元线性回归分析发现年龄（B=52.445，P<0.05）、体重（B=13.077，P<0.05）、透视时间（B=0.425，P<0.05）、管电流(B=0.872，P<0.05)、减影图像数(B=0.660，P<0.05)与KAP值呈正相关，身高和KAP值之间无统计学意义（P>0.05）；结论 3种手术的辐射剂量存在差异性，在满足手术需求的前提下减少透视时间、管电流和减影图像数，对降低患儿所受辐射剂量具有重要意义。

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	商玉秀
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	陈英民

关键词 ：儿童, 先心病, 介入手术, 辐射剂量, CAK, KAP

收稿日期: 2023-07-19

PACS:

X591

基金资助:山东省自然科学基金（ZR2021MH053）；山东第一医科大学（山东省医学科学院）青年科学基金培育资助计划（202201-001）；山东省医药卫生科技发展计划（202012070680）

通讯作者: 陈英民，E-mail：ying2012min@163.com E-mail: ying2012min@163.com

作者简介: 商玉秀（1998—），女，山东聊城人，硕士研究生，研究方向：辐射防护。E-mail：shangyx9898@163.com

引用本文:

商玉秀, 杨显存, 马娅, 王小山, 陈英民. 94例儿童先心病介入手术辐射剂量及影响因素分析[J]. 中国辐射卫生, 2023, 32(6): 673-678.
SHANG Yuxiu, YANG Xiancun, MA Ya, WANG Xiaoshan, CHEN Yingmin. Analysis of radiation dose and influencing factors during interventional procedures for 94 patients with pediatric congenital heart disease. Chinese Journal of Radiological Health, 2023, 32(6): 673-678.

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http://www.zgfsws.com/CN/10.13491/j.issn.1004-714X.2023.06.014 或 http://www.zgfsws.com/CN/Y2023/V32/I6/673

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