上海市放射诊疗发展趋势与医疗照射防护研究

Abstract

Abstract: This paper reviews the rapid development of various types of Radiodiagnosis and Radiotherapy in China and aboard, which leads to a dramatic increase of application frequency of medical exposure. Then summaries the trend found through the investigation on the medical exposure levels during the Eleventh Five-year Plan in Shanghai. According to the above analysis, suggestions to strengthen the medical exposure protection are proposed. When the X-ray diagnosis, interventional radiology, nuclear medicine and radiation oncology become indispensable means to modern medicine, the public exposure due to health examinations and disease diagnosis or treatments has been institutions undergoing X-ray diagnosis in Shanghai by the year of 2010, 2.1 more times of that in 1998. During this period, the total number of X-ray diagnosis equipment increased by 57.7%, and the number of X-CT scanners increased by 131.9%. The annual application frequency of X-ray diagnosis was 780.44 person·time for per 1 000 population in 2009. Compared with the data in 1996, the total frequency increased by 58.3%, and the frequency of X-CT scans increased 317.1%. In clinical nuclear medicine, compared with the data in 1996, the annual application frequencies increased by 139.4% and 210.6% for diagnosis and therapy in 2008, respectively. In the field of radiation oncology, the annual frequency also increased by 59.9% during the same period. Shanghai pioneered the survey on medical exposure levels during the Eleventh Five-Year Plan period in China, and has accumulated a lot of valuable new information and mastered the development trends of medical exposure. This work lays a solid foundation for effectively strengthening the radiation protection from medical exposure, provides a scientific basis for the rational planning and utilization of health care resources. Meanwhile, this work is also very useful for promoting the healthy development of radiology career while avoiding disadvantages and to the benefit of the people.

Key words: Radiodiagnosis and Radiotherapy, medical exposure, radiological protection, development trends, reasonable control

CLC Number:

R144

Zheng Junzheng, Gao Linfeng, Zhuo Weihai, Yao Jie, Wang Bin, Qian Aijun, Ji Guiyi, Xiao Hong. A Trend Study on Radiodiagnosis and Radiotherapy and Radiological Protection for Medical Exposure in Shanghai[J].RADIATION PROTECTION, 2014, 34(5): 265-273.

References

[1] 中华人民共和国卫生部.GBZ/T 146—2002 医疗照射放射防护名词术语[S].北京:法律出版社, 2002.
[2] UNSCEAR.Sources and effects of ionizing radiation,Vol.Ⅰ[M].UNSCEAR 2008 Report.New York:UN,2010.
[3] UNSCEAR.Sources and effects of ionizing radiation, Vol.Ⅰ:Sources[M]. UNSEAE 2000 Report.New York:UN,2000.
[4] 郑钧正.联合国原子辐射效应科学委员会及其报告书概览[J]. 辐射防护通讯, 2011,31(6):32-38.
[5] ICRP.The 2007 Recommendations of the International Commission on Radiological Protection[M].ICRP Publication 103.Oxford:Pergamon Press, 2007.
[6] ICRP. Radiological protection in medicine[M].ICRP Publication 105.Oxford:Pergamon Press, 2008.
[7] Webster EW.X-rays in diagnostic radiology[J]. Health Physics, 1995,69:610-635.
[8] 郑钧正主编.电离辐射医学应用的防护与安全[M]. 北京:原子能出版社,2009.
[9] Leschka S,Stolzmann P,Schmid FT,et al.Low kilovoltage cardiac dual-source CT:Attenuation,noise,and radiation dose[J].European Radiology, 2008,18(9):1 809-1 817.
[10] Lehmuhl L,Gosch D,Nagel HD,et al. Quantification of radiation dose savings in cardiac computed tomography using prospectively triggered mode and ECG pulsing:A phantom study[J].European Radiology, 2010,20(9):2 116-2 125.
[11] 郑钧正.加强医疗照射防护的重点工作(述评)[J].中华放射医学与防护杂志, 2005, 25(2):105-106.
[12] Horner K.Cone-bean computed tomography:time for an evidence-based approach[J].Primary Dental Journal, 2013, 2(1):22-31.
[13] 郑钧正.口腔医学青睐别树一帜的锥形束CT[J].世界医疗器械(IMD), 2013,19(2):42-45.
[14] 郑钧正,贺青华,李述唐,等. 我国电离辐射医学应用的基本现状[J].中华放射医学与防护杂志,2000, 20(增刊):s7-s14.
[15] 李敢.高端医学影像先进医疗器械业发展战略探析[J]. 全球科技经济瞭望, 2011,26(8):67-72.
[16] 郑钧正.放射诊疗的蓬勃发展亟需强化医疗照射防护(专家论坛)[J]. 医学研究杂志,2012,41(10):2-4.
[17] Zheng Junzheng,Sun Fuyin,Jia Delin,et al. Estimation and assessment of population doses from diagnostic X-ray procedures in Beijing[J].Proceedings of the Chinese Academy of Medical Sciences and the Peking Union Medical College,1988,3(1):12-19.
[18] 郑钧正,鲍秀兰,吴毅,等. 北京市X(射)线诊断检查所致公众剂量的估算及评价[J].辐射防护, 1987, 7(5):321-334.
[19] Zheng Junzheng.Annual per caput effective dose equivalent of Beijing inhabitants from diagnostic X-ray procedures[J].Health Physics, 1990,59(6):939-940.
[20] 郑钧正,贺青华,李述唐,等. “九五”期间全国医疗照射水平调查研究[J]. 中华放射医学与防护杂志,2000,20(增刊):s2-s7.
[21] 高林峰,郭常义,郑钧正,等.上海市“十一五”期间医疗照射水平调查研究[J].环境与职业医学,2009,26(6):528-531.
[22] 王彬,郑钧正,高林峰,等. 上海市医用X射线CT的应用频率及其分布研究[J]. 辐射防护,2013, 33(2):65-73.
[23] 高林峰,郑钧正,卓维海,等. 医用X射线CT主要检查类型所致成年受检者剂量研究[J].辐射防护,2013,33(2):74-81.
[24] Yi Yanling,Zheng Junzheng,Zhuo Weihai,et al. Trends in radiation exposure from clinical nuclear medicine procedures in Shanghai,China[J].Nuclear Medicine Communications,2012, 33(3):331-336.
[25] 吴水龙,邵奇,路鹤晴. 上海市X射线诊断医疗照射的频率水平[J].中华放射医学与防护杂志, 2000,20(增刊):s32-s34.
[26] 高林峰,郭常义,沈耀芳,等.2005年上海市X射线诊断的医疗照射频率[J].中华放射医学与防护杂志,2008,28(3):277-278.
[27] 高林峰,郑钧正,卓维海,等. 上海市“十一五”期间X射线诊断的应用频率及其分布研究[J]. 辐射防护, 2014, 34(5):274-280 .
[28] 姚杰,郑钧正,高林峰,等.上海市介入放射学应用现状的调查研究[J]. 辐射防护, 2014,34(5):281-287.
[29] 上海市统计局. 上海统计年鉴——2010[M].北京:中国统计出版社,2010.
[30] 郑钧正. 必须切实强化放射诊疗的安全防护(专家论坛)[J].医学研究杂志, 2011, 40(2):3-5.
[31] 傅征,梁铭会. 数字医学概论[M].北京:人民卫生出版社,2009.
[32] 林志刚.医院信息集成平台的构建与应用[J].中国医疗设备, 2013, 28(9):39-42.
[33] 郑钧正.医学影像数字化所面临新课题应对刍议[J].世界医疗器械(IMD),2010, 16(2): 72-75.
[34] 郑钧正.放射诊疗基本信息资源的开发与利用[J]. 世界医疗器械(IMD),2010, 16(8): 93-95.
[35] 吴毅,王时进,郑钧正,等.估算X射线诊断受检者器官剂量的体模实验方法[J]. 辐射防护, 1987, 7(5):335-340.
[36] 朱志贤,郑钧正,唐文祥,等.X射线诊断所致受检者体表剂量分布特性研究[J].中华放射医学与防护杂志,2000, 20(增刊):s71-s73.
[37] 朱志贤,郑钧正,唐文祥,等.X射线诊断所致受检者剂量的表征与监测方法[J]. 中国辐射卫生,2003,12 (3):129-133.
[38] 郑钧正,卓维海.当前放射卫生领域重点研究方向(述评)[J].中国公共卫生,2008, 24(4):385-387.
[39] 刘海宽,卓维海,郑钧正.X射线诊断所致受检者辐射剂量的表征与评估研究进展[J].中国医学物理杂志,2008, 25(2):547-551.
[40] ICRP.Managing patient dose in computed tomography[M].ICRP Publication 87.Oxford:Pergamon Press,2001.
[41] Fred A Mettler,Bruce R Thomadsen,Mythreyi Bhargavan,et al. Medical radiation exposure in the U.S. in 2006:preliminary results[J].Health Phys, 2008, 95(5):502-507.
[42] NCRP. Ionizing radiation exposure of the population of the United States[M].NCRP Publication 160.Bethesda MD:NCRP, 2009.
[43] 郑钧正. 我国放射防护新基本标准强化对医疗照射的控制[J].辐射防护 ,2004,24(2):74-91.
[44] 郑钧正.不断追求医学影像质量与患者辐射剂量的优化匹配[J]. 中国医疗设备, 2010, 25(9):6- 9.
[45] ICRP.Radiological protection in paediatric diagnostic and interventional radiology[M]. ICRP Publication 121.Oxford:Pergamon Press, 2013.
[46] 郑钧正,李君利.关注现代医学物理进展,加强医用辐射防护[J]. 辐射防护,2008,28(6):377-384.
[47] Balter S,Hopewell JW,Miller DL,et al.Fluoroscopically guided interventional procedures:a review of radiation effects on patients’skin and hair[J].Radiology, 2010,254:326-341
[48] 白玫,刘彬,郑钧正. 心脏介入患者受照剂量研究[J]. 介入放射学杂志, 2007,16(4):222-225.
[49] ICRP. Avoidance of radiation injuries from medical interventional procedures[M].ICRP Publication 85.Oxford:Pergamon Press, 2000.

A Trend Study on Radiodiagnosis and Radiotherapy and Radiological Protection for Medical Exposure in Shanghai

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