TĂNG sử dụng intraoperative fluoroscopy tiếp xúc với các khoản tiền bác sĩ phẫu thuật quan trọng của bức xạ. Việc tiếp xúc hàng năm trung bình của công chúng với bức xạ ion hóa IS 360 millirem (mrem) của 300 IS mrem nào từ bức xạ nền và mrem 60 từ radiographers chẩn đoán. | Occupational Radiation Exposure to the Surgeon Gordon Singer MD MS Abstract Increased use of intraoperative fluoroscopy exposes the surgeon to significant amounts of radiation. The average yearly exposure of the public to ionizing radiation is 360 millirems mrem of which 300 mrem is from background radiation and 60 mrem from diagnostic radiographs. A chest radiograph exposes the patient to approximately 25 mrem and a hip radiograph to 500 mrem. A regular C-arm exposes the patient to approximately 1 200 to 4 000 mrem min. The surgeon may receive exposure to the hands from the primary beam and to the rest of the body from scatter. Recommended yearly limits of radiation are 5 000 mrem to the torso and 50 000 mrem to the hands. Exposure to the hands may be higher than previously estimated even from the mini C-arm. Potential decreases in radiation exposure can be accomplished by reduced exposure time increased distance from the beam increased shielding with gown thyroid gland cover gloves and glasses beam collimation using the low-dose option inverting the C-arm and surgeon control of the C-arm. J Am Acad Orthop Surg 2005 13 69-76 As instrumentation and surgical technique advance surgeons increasingly depend on fluoroscopy for intraoperative imaging. Procedures that often require intraoperative fluoroscopy include fracture reduction intramedullary rodding percutaneous techniques requiring cannulated and headless screws Kirschner wire and external fixator pin placement hardware and foreign body removal stability assessment guidance of bone biopsy and cyst aspiration. Increased use of fluoroscopy exposes the surgeon to potentially harmful levels of radiation. The surgeon often must remain close to the x-ray beam and therefore cannot use distance to reduce radiation exposure. How much radiation surgeons receive is an issue of concern and how much is considered safe is a matter of periodic revision. Medical physics is rarely taught in surgical programs and little .
