术中C形臂X射线机的优化使用

目的]优化术中C形臂X射线机的使用参数,有效减少其对操作者和患者的X射线辐射。方法]用人体模型模拟手术,在连续透视、脉冲透视和高对比度透视3种模式下,分别对机器内置5个固定程序（P1-P5）的剂量面积乘积（DAP）参数进行比较,并使用骨盆（P2）程序按照欧共体（CEC）影像质量标准对在脉冲透视和高对比透视模式下的骨盆透视影像进行质量评价。结果]3种不同模式下使用同一内置程序,DAP差异有统计学意义（P〈0.01）;各程序在脉冲透视模式下的DAP值比连续透视模式和高对比度透视模式低（P〈0.01）;同一模式下的不同内置程序,DAP差异有统计学意义（P〈0.01）。腰椎（P3）程序的DAP值最高,与其他内置固定程序比较差异有统计学意义（P〈0.01）;通过CEC影像质量标准评分分析,使用骨盆（P2）程序在脉冲透视和高对比透视模式下所得骨盆透视影像,两者影像质量的差异无统计学意义,但DAP值明显增加（P〈0.01）,而在脉冲透视模式下骨盆（P2）和四肢（P4）所得骨盆透视影像质量有统计学意义。结论]正确合理地使用C形臂X射线机参数,能有效降低医护人员及患者的辐射伤害。

Intraoperative Parameter Optimization of C-Arm X-Ray Apparatus

Objective ] To optimize intraoperative parameters of C-arm X-ray apparatus and to effectively reduce radiation exposures to operators and patients. Methods ] In human model stimulation surgery, parameters of dose area product （DAP） of 5 built-in fixed programs （P1-P5） were compared under continuous fluoroscopy, pulsed fluoroscopy and high contrast fluoroscopy modes. Pelvis （P2） image qualities in pulsed fluoroscopy and high-contrast perspective modes were evaluated in accordance with the image quality standards by Commission of the European Community （CEC）. Results ] There were significant differences in the DAP values of the same program among three modes （P〈 0.01）. The DAP values were lower in the pulsed fluoroscopy mode than in the continuous fluoroscopy mode and the high contrast fluoroscopy mode （P 〈 0.01）. There were significant differences in the DAP values under the same mode among different programs （P〈0.01）. The DAP value was found significantly higher in the lumbar spine （P3） program than in other programs （P 〈 0.01）. There was no significant difference in the image qualities between pulsed fluoroscopy and high-contrast perspective modes, but the DAP values were increased significantly （P 〈 0.01）. There were significant differences in the image qualities under pulsed fluoroscopy mode between P2 and limbs （P4） programs. Conclusion ] Correct and reasonable use of the parameters of C-arm X-ray apparatus can effectively reduce radiation damage to medical professionals and patients.