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目的分析碘-131(~(131)I)治疗后分化型甲状腺癌(DTC)患者外照射辐射剂量。方法采用方便抽样方法,选择2016年4~9月行~(131)I治疗的10例DTC患者为研究对象。采用X、γ剂量率仪检测患者在服用~(131)I后2、24、48、72、96、120、144、168 h颈前体表及正面距离颈前体表1.0、2.0、3.0 m的外照射辐射剂量率;采用热释光探测器检测患者服用~(131)I治疗后1~7 d的外照射辐射累积剂量及治疗后7 d周围环境的累积剂量。结果患者服用~(131)I后2 h颈前体表外照射辐射剂量率>1 100.00μSv/h,72 h后距患者颈前体表2.0 m处的剂量率降至0.90~2.12μSv/h;96 h后距患者颈前体表1.0 m处的剂量率降至0.60~2.30μSv/h。患者服用~(131)I后第2天累积剂量当量高于第1天(P<0.01),第3、4、5、6、7天累积剂量当量均高于第1、2天(P<0.01)。患者服药后连续7 d测得的距离患者病床1.0 m处、卫生间马桶外侧、隔壁房间墙壁的累积剂量当量中位数分别为3.58、6.11和0.85 mSv。结论 DTC患者接受~(131)I治疗后需住院治疗,住院期间需采取综合防护措施,~(131)I治疗4 d后出院较为合适。
Objective To analyze the external radiation dose of differentiated thyroid carcinoma (DTC) patients after iodine-131 (~ (131) I) treatment. Methods Convenient sampling method was used to select 10 DTC patients treated with ~ (131) I from April to September in 2016. The X, γ dose-rate meter was used to detect the distance between the cervical precancerous surface and the frontal surface of cervical precursors at 1,24,48,72,96,120,144,168 h after taking 131I, 1.0,2.0,3.0 m The cumulative dose of external radiation dose and the accumulated dose of the surrounding environment on the 7th day after treatment were measured by the thermoluminescence detector at 1 ~ 7 days after treatment with ~ (131) I. Results The dose rate of extracorporeal radiation was> 1 100.00μSv / h 2 hours after taking 131I, and the dose rate at 2.0 m from the cervical prepuce dropped to 0.90-2.12μSv / h after 72 hours ; The dose rate at 1.0 m from the anterior cervical surface of the patient dropped to 0.60 ~ 2.30μSv / h after 96 h. The cumulative dose equivalent of the second day after taking 131I was higher than that of the first day (P <0.01), and the cumulative dose equivalent of the first, the third, the fifth, the sixth, and the seventh day was higher than that of the first day (P < 0.01). The cumulative median dose-equivalent of 1.0m at patient bedside, toilet outside toilet bowl, and wall of next room measured at 7 consecutive days after taking the drug was 3.58, 6.11 and 0.85 mSv, respectively. Conclusions DTC patients need hospitalization after ~ (131) I treatment, comprehensive protective measures should be taken during hospitalization, and it is more appropriate to discharge after 131I treatment for 4 days.