如何减少经桡动脉介入治疗的放射线损伤(CIT).ppt

LONG-TERM CANCER RISK In summary, there is some evidence that occupational exposure increases the incidence of cancer, particularly female breast cancer or leukemia, but the evidence is weak at current exposure levels. Am Heart J, 2009; 157: 118-24 How to minimizing X-ray injury to the patient ? Position the detector as close to the patient as practicable, with the x-ray tube as far from the patient as possible. Careful review of the patient’s history If the detector is positioned far from the patient, the image may be blurred, the ?uoroscopic machine in ABC (automatic brightness control) mode will automatically increase the kVp or mA, or both, to improve the image brightness, this results in increased radiation dose to the patient. Use the exposure pedal as sparingly as possible. Radiation exposure during ?uoroscopy is directly proportional to the length of time the unit is activated by the foot pedal switch. U.S. FDA guidelines require that the total elapsed ?uoroscopy time be recorded in the patient record for every patient procedure. “heavy foot” on the X-ray pedal Use a low pulse rate ?uoroscopy Decrease from 30 pulses to 15 or 7.5 pulses per second whenever possible. View and save images with last-image-hold/ fluoro-store. This allows for storing and reviewing of the last image without re-exposing the patient to more radiation. Alter the position of the beam if possible, particularly during long cases, to avoid a prolonged exposure to one small area of skin. Use magni?cation only when necessary In the ABC mode, more radiation is used to brighten and sharpen the image during magni?cation. Make sure that extraneous body parts are out of the ?eld. … but do not stop after 60 min fluoro when the case is progressing, all the risk were in vain. A large dose given in a short amount of time is more damaging than the same dose given over a longer period of time. Fractionation of t