| 唐利军,周文珊,刘盛,杨想军,霍细香,谢曙光,李静,刘安生,唐诗迪,雷子乔,陈为民,牛延涛.新型冠状病毒肺炎放射诊断检查场所的感染控制与辐射安全监测和分析[J].中华放射医学与防护杂志,2020,40(4):253-258 |
| 新型冠状病毒肺炎放射诊断检查场所的感染控制与辐射安全监测和分析 |
| Investigation and analysis on the infection control and radiation safety of radiodiagnostic workplace for COVID-19 |
| 投稿时间：2020-03-04 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.04.001 |
| 中文关键词: 新型冠状病毒肺炎 放射诊断场所 辐射安全 感染控制 方舱CT |
| 英文关键词:COVID-19 Radiodiagnostic workplace Radiation safety Infection control Module CT |
| 基金项目:国家科技基础资源调查专项（2017FY101201） |
| 作者 | 单位 | E-mail | | 唐利军 | 湖北省疾病预防控制中心 应用毒理湖北省重点实验室, 武汉 430079 | | | 周文珊 | 湖北省疾病预防控制中心 应用毒理湖北省重点实验室, 武汉 430079 | | | 刘盛 | 湖北省疾病预防控制中心 应用毒理湖北省重点实验室, 武汉 430079 | | | 杨想军 | 湖北省疾病预防控制中心 应用毒理湖北省重点实验室, 武汉 430079 | | | 霍细香 | 湖北省疾病预防控制中心 应用毒理湖北省重点实验室, 武汉 430079 | | | 谢曙光 | 湖北省疾病预防控制中心 应用毒理湖北省重点实验室, 武汉 430079 | | | 李静 | 湖北省疾病预防控制中心 应用毒理湖北省重点实验室, 武汉 430079 | | | 刘安生 | 武汉市职业病防治院 430015 | | | 唐诗迪 | 湖北省疾病预防控制中心 应用毒理湖北省重点实验室, 武汉 430079 | | | 雷子乔 | 华中科技大学同济医学院附属协和医院放射科, 武汉 430022 | | | 陈为民 | 武汉大学中南医院科研处 430071 | | | 牛延涛 | 首都医科大学附属北京同仁医院放射科, 北京 100730 | ytniu163@163.com |
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| 中文摘要: |
| 目的 对新型冠状病毒肺炎放射诊断场所存在的感染控制和辐射安全风险进行调查和监测，为放射技师及相关工作人员的安全防护提供数据支持。方法 根据国家标准（WS 519-2019和GBZ 130-2013）对湖北省4所未启用的应急医院（"小汤山式"甲、乙医院及方舱医院、砖混模式医院）中新安装的8台CT及其场所进行成像性能和放射防护检测并评价。对机房布局等感染控制安全的因素实施了监测与调查。选择定点医院2所（综合医院和传染病专科医院），通过现场调查和对4个CT机房环境生物样本进行新型冠状病毒核酸检测，对放射场所的布局、感染防控和核酸检测结果的分布进行分析，评价其生物安全的可靠性和风险点。结果 应急医院的8台CT设备的成像性能和放射防护指标均能满足国家标准的要求。甲、乙医院各有3个CT机房，面积均为38.8 m2和4 mm Pb当量的屏蔽防护；方舱医院和砖混建筑医院的CT机房面积和屏蔽防护分别为20.0 m2、4 mm Pb当量和35.8 m2、3 mm Pb当量。8个放射诊断场所符合感染防控"三区两通道"的设计要求。新型冠状病毒核酸检测结果显示，CT机房内患者触碰到的多个位点如检查床、机架内侧、地面等多处发现核酸阳性。放射技师通过手部、足底沾染造成操作间内操作台和地面的病毒污染风险。此外，机房内患者未触及的区域如观察窗和排风口等处也出现类似阳性。结论 4所应急医院的8台CT设备和机房基本满足成像性能和放射防护要求。新型冠状病毒肺炎放射诊断检查场所需加强消毒的规范化。 |
| 英文摘要: |
| Objective To survey and supervise the risk of infection control and radiation safety in the radiological diagnostic workplace for COVID-19, and provide data support for the safety protection of radiographers and related staff. Methods 4 emergency hospitals for COVID-19 including 2 makeshift hospitals, module hospital and brick pattern hospital in Hubei province were performed for testing and evaluation of imaging performance and radiological protection for the 8 new installed CT scanners and places according to the national standards of WS 519-2019 and GBZ 130-2013. The infection control safety factors such as the layout of the equipment room were monitored and investigated. Two COVID-19 designated hospitals including general hospital and infectious disease specialized hospital were selected to carry out field investigation and sampling of environmental biological samples for 4 CT rooms. Then the samples were detected for the nucleic acid of novel coronavirus. The results of radiodiagnostic workplace overall arrangement, infection prevention and the nucleic acid testing were analyzed, and the biological safety reliability and risk point were evaluated. Results The indicators of imaging performance and radiation protection for 8 CT scanners in emergency hospitals could meet the requirements of national standards.Each of 2 makeshift hospitals had 3 CT rooms with the area of 38.8 m2 and 4 mm Pb equivalent thickness of protective shielding. The CT rooms in module hospital and brick pattern hospital were 20.0 m2, and 35.8 m2 in areas, with 4 mm Pb equivalent and 3 mm Pb equivalent thickness of protection shielding, respectively. The 8 radiological diagnostic workplaces of the emergency hospitals were designed and constructed based on "three zones with two passage ways ". The result of the nucleic acid test indicated that the positive samples were found at the multiple sites such as scanning bed, internal of gantry and ground touched by patients in CT scanning room. The areas such as console panel and ground were risked of pollution by the virus infected hands and feet of radiographers. In addition, the similar positive samples were found in the areas in scanning room with no touch of patients, such as observation window and air outlet. Conclusions 8 CT scanners and rooms in 4 emergency hospitals basically meet the requirements of imaging performance and radiation protection. The disinfection of COVID-19 radiodiagnostic workplace should be standardized. |
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