آموزش و اخلاق در پرستاری
Education and Ethics In Nursing ISSN: 2322-5300

روش‌های محافظت از اندام‌های تولید مثل در مراکز رادیولوژی: یک مطالعۀ مروری – نقلی

https://doi.org/10.22034/ethic.2024.2034551.1079
دوره 13، ویژه نامه ارتقا سلامت
تیر 1403
صفحه 30-41
آموزش و اخلاق در پرستاری

نوع مقاله : مقاله مروری

نویسندگان

ابوالفضل کوزری 1
محمدرضا الهایی 2
محمدرضا نظریان 1
ایرج عابدی 2

1 گروه فیزیک پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران

2 گروه فیزیک پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده
مقدمه:در تصویربرداری توسط اشعۀ ایکس، با توجه به حضور اندام­های حساس در معرض اشعه، مخصوصاً اندام­های تولید مثلی(خطر سرطان و پیامدهای ژنتیکی ) نیاز است که روش ­های محافظت از آن­ها در برابر تشعشع­ های یونیزان، به دقت مورد محافظت قرار گیرد؛ بنابراین پژوهش حاضر، با هدف تعیین روش‌های محافظت از اندام­های تولید مثل در مراکز رادیولوژی طراحی و اجرا گردید.
روش ­کار: پژوهش حاضر، از نوع مروری- نقلی بود که با استفاده از کلید واژه­های فارسی و معادل انگلیسی «تصویربرداری با اشعۀ ایکس»،« شیلد‌های لگنی»، «حفاظت در برابر تشعشع یونیزان»، «ایمنی اندام‌های تولید مثل»، «کامپوزیت‌های سیلیکون رابر-سرب»، در پایگاه­های اطلاعاتی"scholar  Google، ScienceDirect" و بدون محدودۀ زمانی با زبان فارسی و انگلیسی، توسط دو محقق به صورت مجزا انجام شد. تعداد 121 مقاله، با متن کامل بر اساس چک ­لیست­های معتبر "Newcastle-Ottawa و  AMSTAR" ارزیابی و 24 مورد آن­ها وارد مطالعه شدند.
یافته ­ها: محافظ ­های تماسی، بیشتر به کار گرفته شدند؛ زیرا اندازه و شکل آن­ها تابعی از سن و جنسیّت بیمار بود. استفادۀ مؤثر محافظ، تنها شامل قرار دادن آن نیست؛ بلکه باید به‌طور مرتب بررسی شود تا از آسیب‌های احتمالی پیشگیری گردد. محافظ‌ های آسیب‌دیده، حتی اگر درست استفاده شوند، نقش محافظی خود را ایفا نمی‌کنند. برای رادیوگرافی لگن، محافظ بیسموتی می‌تواند دوز دریافتی بیمار را کاهش دهد، بدون اینکه بر کیفیت تصویر تأثیر بگذارد.
نتیجه ­گیری: تحقیقات، تأکید بر اثربخشی حفاظت از اندام­های تولید مثلی به کمک محافظ­های سیلیکونی سالم، در کاهش دوز تابش بدون تأثیر منفی بر ارزش تشخیصی دارند.

کلیدواژه‌ها

تصویربرداری
اشعۀ ایکس
محافظ
تشعشع یونیزان
ایمنی
اندام‌های تولید مثل
موضوعات

عنوان مقاله English

Protective Methods for Reproductive Organs in Radiology Centers: A Narrative: Review Study

نویسندگان English

Abolfazl Koozari 1
Mohammadreza Elhaie 2
Mohammadreza Nazarian 1
Iraj Abedi 2
1 Department of Medical Physics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2 Department of Medical Physics, School of Medicine Isfahan University of Medical Sciences, Isfahan, Iran
چکیده English

Introduction: In radiographic imaging using X-rays, due to the presence of radiation sensitive organs, especially the reproductive organs (risk of cancer and genetic consequences), it is necessary that protection methods for them against ionizing radiations be carefully protected. Therefore, the present study was designed and implemented with the aim of determining protection methods for reproductive organs in radiology centers.
Methods & Materials: This study was conducted as a review – narrative type by using key phrases and words with the Persian and English keyword equivalents of "X-ray imaging", "pelvic shields", "ionizing radiation protection", "reproductive organ safety", "silicon rubber-lead composites" in Google Scholar, ScienceDirect databases without any time limitations and in Persian and English languages separately by two researchers. 121 full-text articles were evaluated based on the validated Newcastle-Ottawa and AMSTAR checklists and 24 of them were included in the study.
Results: Contact shields were used more frequently and their size and shape depended on the patient's age and gender. Effective use of shields involves not only their placement but also their regular checks to prevent possible damages. Damaged shields, even if used correctly, do not fulfill their protective role. For pelvic radiography, a bismuth shield can reduce the patient's received dose without affecting image quality.
Conclusion: The research emphasizes the effectiveness of protecting the reproductive organs by using healthy silicon shields in reducing radiation dose without negatively impacting the diagnostic value.

کلیدواژه‌ها English

  • X-Ray
  • Imaging
  • Shield
  • Ionizing Radiation
  • Safety
  • Reproductive Organs
  1. Chan C, Fung K. Dose optimization in pelvic radiography by air gap method on CR and DR systems–A phantom study. Radiography. 2015;21(3):214-23.
  2. Hall E, Giaccia A. Radiobiology for the radiologist. Philadelphia: Lippin‐cott Williams & Wilkins; 2012.
  3. Protection R. ICRP publication 103. Ann ICRP. 2007;37(2.4):2.
  4. Doolan A, Brennan PC, Rainford LA, Healy J. Gonad protection for the antero-posterior projection of the pelvis in diagnostic radiography in Dublin hospitals. Radiography. 2004;10(1):15-21.
  5. Karami V, Zabihzadeh M, Gholami M. Gonad Shielding for Patients Undergoing Conventional Radiological Examinations: Is There Cause for Concern? 2016.
  6. Frantzen MJ, Robben S, Postma AA, Zoetelief J, Wildberger JE, Kemerink GJ. Gonad shielding in paediatric pelvic radiography: disadvantages prevail over benefit. Insights into imaging. 2012;3:23-32.
  7. Karami V, Zabihzadeh M, Shams N. Bismuth radioprotective gonadal shields: prevalence of use and effect on image quality during paediatric pelvic radiography. Hong Kong Journal of Radiology. 2018;21(3):178-83.
  8. Wang B, Ting C-Y, Lai C-S, Tsai Y-S. Bismuth Pelvic X‐Ray Shielding Reduces Radiation Dose Exposure in Pediatric Radiography. BioMed research international. 2021;2021(1):9985714.
  9. Lopresti M, Alberto G, Cantamessa S, Cantino G, Conterosito E, Palin L, et al. Light weight, easy formable and non-toxic polymer-based composites for hard x-ray shielding: a theoretical and experimental study. International journal of molecular sciences. 2020;21(3):833.
  10. Sreenivasan SK, Lolayekar N, Sheth P, Rao D. Knowledge, attitude, and practices of parents toward pediatric dental radiography. Journal of Health and Allied Sciences NU. 2022;12(04):448-53.
  11. Ofori EK, Antwi WK, Scutt DN, Ward M. Patient radiation dose assessment in pelvic X-ray examination in Ghana. OMICS J Radiology. 2013;2(8):1-5.
  12. Ofori EK, Antwi WK, Scutt DN, Ward M. Optimization of patient radiation protection in pelvic X‐ray examination in Ghana. Journal of Applied Clinical Medical Physics. 2012;13(4):160-71.
  13. Alzyoud K, England A, Snaith B, Flintham K, Hogg P, editors. Impact of fat thickness on AP pelvis radiography image quality and effective dose2018: European Congress of Radiology-ECR 2018.
  14. Protection ICoR. Protection of the Patient in Diagnostic Radiology: A Report of Committee 3 of the International Commission on Radiological Protection: Pergamon Press; 1982.
  15. Jeukens C, Kütterer G, Kicken PJ, Frantzen MJ, van Engelshoven JMA, Wildberger JE, et al. Gonad shielding in pelvic radiography: modern optimised X-ray systems might allow its discontinuation. Insights Imaging. 2020;11(1):15.
  16. Krepler P, Vana N, Havranek C. Dosimetric studies in the radiological examination of the hips in young infants with a special fenestration method of gonad protection. Pediatric radiology. 1977;5:231-5.
  17. Abram E, Wilkinson D, Hodson C. Gonadal protection from X radiation for the female. The British Journal of Radiology. 1958;31(366):335-6.
  18. Stam W, Pillay M. Inspection of lead aprons: a practical rejection model. Health physics. 2008;95(2):S133-S6.
  19. Karami V, Zabihzadeh M, Shams N, Gholami M. Radioprotection to the gonads in pediatric pelvic radiography: effectiveness of developed bismuth shield. Int J Pediatr. 2017;5(6).
  20. Karami V, Zabihzadeh M, Shams N, Malehi AS. Gonad shielding during pelvic radiography: a systematic review and meta-analysis. Archives of Iranian Medicine. 2017;20(2):0-.
  21. Gursu S, Gursu T, Camurcu İ, Yildirim T, Gursu A, Sahin V. Efficacy of gonadal shielding in pediatric pelvis X-rays. EKLEM HASTALIKLARI VE CERRAHISI-JOINT DISEASES AND RELATED SURGERY. 2013;24(2).
  22. Pasieka E, Żelechowicz M, Milewski R. Analysis of frequency and effectiveness of gonad shield use during diagnostic hip radiology. EJMT. 2017;1:14.
  23. Warlow T, Walker-Birch P, Cosson P. Gonad shielding in paediatric pelvic radiography: Effectiveness and practice. Radiography. 2014;20(3):178-82.
  24. Liakos P, Schoenecker PL, Lyons D, Gordon JE. Evaluation of the efficacy of pelvic shielding in preadolescent girls. Journal of Pediatric Orthopaedics. 2001;21(4):433-5.
  25. MacKay M, Hancy C, Crowe A, D'Rozario R, Ng C. Attitudes of medical imaging technologists on use of gonad shielding in general radiography. Radiographer. 2012;59(2):35-9.
  26. AAPM P. 32-A: AAPM position statement on the use of patient gonadal and fetal shielding. 2019.
  27. O'Sullivan J, O'Connor OJ, O'Regan K, Clarke B, Burgoyne LN, Ryan MF, et al. An assessment of medical students' awareness of radiation exposures associated with diagnostic imaging investigations. Insights Imaging. 2010;1(2):86-92.
  28. Lee MC, Lloyd J, Solomito MJ. Poor utility of gonadal shielding for pediatric pelvic radiographs. Orthopedics. 2017;40(4):e623-e7.
  29. Somasundaram E, Brady SL, Strauss KJ. Achievable dose reductions with gonadal shielding for children and adults during abdominal/pelvic radiographic examinations: a Monte Carlo simulation. Medical Physics. 2020;47(11):5514-22.
  30. Kaplan SL, Magill D, Felice MA, Xiao R, Ali S, Zhu X. Female gonadal shielding with automatic exposure control increases radiation risks. Pediatric radiology. 2018;48:227-34.
  31. Hiles P, Gilligan P, Damilakis J, Briers E, Candela-Juan C, Faj D, et al. European consensus on patient contact shielding. Insights. Imaging. 2021;12(1).
  32. Fawcett S, Barter S. The use of gonad shielding in paediatric hip and pelvis radiographs. The British Journal of Radiology. 2009;82(977):363-70.
  33. Fawcett S, Gomez A, Barter S, Ditchfield M, Set P. More harm than good? The anatomy of misguided shielding of the ovaries. The British Journal of Radiology. 2012;85(1016):e442-e7.
  34. Bardo DM, Black M, Schenk K, Zaritzky MF. Location of the ovaries in girls from newborn to 18 years of age: reconsidering ovarian shielding. Pediatric radiology. 2009;39:253-9.
  35. Tsai Y-S, Liu Y-S, Chuang M-T, Wang C-K, Lai C-S, Tsai H-M, et al. Shielding during x-ray examination of pediatric female patients with developmental dysplasia of the hip. Journal of Radiological Protection. 2014;34(4):801.
  36. Fawcett SL, Gomez AC, Barter SJ, Ditchfield M, Set P. More harm than good? The anatomy of misguided shielding of the ovaries. Br J Radiol. 2012;85(1016):e442-7.
  37. Clancy CL, O'Reilly G, Brennan PC, McEntee MF. The effect of patient shield position on gonad dose during lumbar spine radiography. Radiography. 2010;16(2):131-5.
  38. Wainwright A. Shielding reproductive organs of orthopaedic patients during pelvic radiography. Annals of the Royal College of Surgeons of England. 2000;82(5):318.
  39. Padovani R. The importance of education and training in reducing patient doses. European Radiology Supplements. 2004;14:2-8.
  40. Ribeiro L, Yoshimura EM. Entrance surface dose measurements in pediatric radiological examinations. Radiation measurements. 2008;43(2-6):972-6.
  41. Laal M. Innovation process in medical imaging. Procedia-Social and Behavioral Sciences. 2013;81:60-4.
  42. Miller DL, Schauer D. The ALARA principle in medical imaging. philosophy. 1983;44(6):595-600.

صفحه اصلی

راهنمای نویسندگان

ارسال مقاله

تماس با ما