通讯作者: 叶伟, yewei0720@163.com

DOI：10.12201/bmr.202509.00036

Effect Evaluation of mobile combined lead shields on Reducing Gonadal Radiation Dose to Operators During TIPS Procedures：A Randomized Controlled Trial

• 摘要：摘要 目的 评价移动式组合铅挡板对经颈静脉肝内门体分流术(Transjugular intrahepatic portosystemic shunt, TIPS)术者性腺辐射剂量的防护效果。方法 本研究采用随机对照试验设计，共纳入40例TIPS手术，通过随机数字表法分为试验组（n=20）和对照组（n=20），试验组在手术中使用移动式组合铅挡板对性腺进行防护，对照组则不使用该装置，同时使用直读式电子剂量计实时测量并记录第一术者和第二术者性腺部位的辐射剂量，比较两组术者性腺辐射剂量差异。结果 两组手术成功率为100%，与对照组相比，试验组第一术者和第二术者的性腺辐射剂量分别由113.15（58.86, 162.75）μSv和99.82（48.31, 132.84）μSv降至 29.19（18.40, 60.05）μSv和 33.33（19.99, 47.53）μSv；辐射剂量率分别由247.41（175.43, 286.97）μSv /h和199.72（145.74, 268.35）μSv/h降至76.36（62.77, 118.35）μSv/h和80.95（64.25, 92.37）μSv/h，两组数据差异均具有统计学意义（均P<0.001）。结论 在TIPS手术中，移动式组合铅挡板可有效降低TIPS术者性腺辐射剂量，显著改善该术式中术者的辐射防护，为 TIPS 术者性腺防护提供实用且合规的补充方案。

  关键词： 移动式组合铅挡板；经颈静脉肝内门体分流术；性腺；辐射防护；辐射剂量; ; ; ; 

   

  Abstract: Abstract Objective To evaluate the protective effect of a mobile combined lead shield on gonadal radiation dose for operators during Transjugular Intrahepatic Portosystemic Shunt (TIPS) placement.Methods A total of 40 TIPS procedures were included in this randomized controlled trial. Participants were allocated via a random number table into an experimental group (n = 20), in which a mobile combined lead shield was deployed for gonadal protection during the procedure, or a control group (n = 20) that received no additional shielding. A direct-reading electronic dosimeter was used to measure and record real-time radiation exposure at the gonadal region for both the primary and secondary operators. The gonadal radiation doses were then compared between the two groups.Results The technical success rate was 100% in both groups. Compared to the control group, the median gonadal radiation dose in the experimental group significantly decreased from 113.15 （58.86, 162.75）μSv to 29.19（18.40, 60.05）μSv for the primary operator and from 99.82（48.31, 132.84）μSv to 33.33（19.99, 47.53）μSv for the secondary operator. Similarly, the median dose rate decreased from 247.41（175.43, 286.97）μSv/h to 76.36（62.77, 118.35）μSv/h for the primary operator and from 199.72（145.74, 268.35）μSv/h to 80.95 （64.25, 92.37）μSv/h for the secondary operator. All these differences were statistically significant (P<0.001 for all comparisons).Conclusion During TIPS procedures, the use of a mobile modular lead shield effectively reduces the gonadal radiation dose to operators. It significantly improves radiation protection for operators in this specific procedure, providing a practical and compliant supplementary solution for gonadal shielding in TIPS operators.

  Key words: Mobile combined lead shield; Transjugular Intrahepatic Portosystemic Shunt; Gonads; Radiation protection; Radiation dose

  提交时间：2025-09-15

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  1	2025-08-20	10.12201/bmr.202509.00036V1	下载

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