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目的掌握医疗卫生机构职业性放射性疾病的发病特点、规律和趋势,为制定职业性放射性疾病防治政策和国家放射卫生标准提供科学依据。方法采用填报调查表、现场核实与实验室监测相结合的方法,对云南省昆明市的放射诊疗机构放射防护情况及放射工作人员个人剂量等进行调查与监测。结果基本掌握了昆明市169家放射诊疗机构的基本情况、放射防护情况和282家放射治疗机构的个人剂量监测情况。昆明市一级、二级医院主要使用的诊疗设备是X射线影像诊断设备,部分一级和二级医院仍使用落后的放射诊疗设备(荧光屏透视机)。全部医院均配备有相应数量的X射线影像诊断防护用品和辅助防护设施,其中铅橡胶围裙数量最多,铅防护屏风数量最少。个人防护用品工作人员人均占有率高于全国平均水平。个人剂量监测中,未发现年个人剂量Hp(10)≥20 mSv的放射工作人员。从事介入放射学和核医学的工作人员铅衣外个人剂量当量Hp(10)约为铅衣内的6倍和2倍,提示单纯采用铅衣内剂量计读数可能会低估放射工作人员的受照剂量。结论应为放射工作人员配备更多的个人防护用品,尤其是介入放射学和核医学工作人员。尽快淘汰落后的放射诊疗设备(荧光屏透视机)。进一步加强放射工作人员个人剂量监测工作,明确介入放射学工作人员的铅围裙内外各佩戴一个剂量计,加强核医学工作人员的内照射监测工作。
Objective To grasp the characteristics, laws and trends of occupational radiation diseases in medical and health institutions and provide a scientific basis for formulating prevention and control policies of occupational radiation diseases and national radiation health standards. Methods The method of filling in questionnaires, on-site verification and laboratory monitoring was used to investigate and monitor the radiation protection status of radiation clinics in Yunnan Province and the personal dose of radiation workers. The results basically mastered the basic situation of 169 radiology clinics in Kunming, the situation of radiological protection and the personal dose monitoring of 282 radiotherapy institutions. Kunming primary and secondary hospitals are mainly used diagnostic equipment is X-ray diagnostic imaging equipment, some of the first and second-class hospitals are still using backward radiotherapy equipment (fluoroscopy machine). All hospitals are equipped with a corresponding number of X-ray diagnostic imaging equipment and supplementary protective equipment, including the largest number of lead rubber aprons, lead the minimum number of protective screens. Personal protective equipment per capita occupancy rate higher than the national average. Individual dose monitoring, no annual personal dose Hp (10) ≥ 20 mSv radiation workers were not found. Individual workers who engaged in interventional radiology and nuclear medicine had a personal Hp (10) equivalent to 6 times and 2 times the lead outside the lead, suggesting that using a lead-in dosimeter alone may underestimate the exposure of radiation workers dose. Conclusion Radiological staff should be equipped with more personal protective equipment, especially interventional radiology and nuclear medicine staff. Quickly eliminate outdated radiotherapy equipment (screen fluoroscopy machine). To further strengthen the personal radiation dose monitoring staff, clearly involved in the staff of the lead aprons outside the lead aprons to wear a dosimeter to strengthen nuclear medicine staff to monitor the internal radiation.