降低嬰幼兒胸腹部x光攝影之重照率

在臨床攝影中，嬰幼兒常因哭鬧、不願配合照相等因素，導致影像重照，而嬰幼兒接受輻射致癌機率較成人為高，故本研究希望瞭解嬰幼兒X光攝影重照之因素，提出改進方案，減低重照率，以減少重照所造成額外的輻射劑量。本研究係自行開發製作嬰幼兒X光照像輔助器材，幫助約束嬰幼兒肢體，利用貼紙、小玩具、花俏的鉛衣及撥放卡通音樂等方式來安撫小朋友情緒，營造嬰幼兒攝影檢查的環境及衛教家屬正確的固定嬰幼兒肢體，達到有效且安全之嬰幼兒X光影像檢查。影像模糊衍生之重照率由2.79%降低至0.75%，降幅72.98%（p＜0.001），不能配合擺位引起古巴位偏移所衍生之重照率由2.06%減降低至0.34%，降幅83.70%（p ＜0.001），因異物產生假影重照率由0.88%降低至0.42%，降幅52.47%（p＞0.05）。整體重照率由6.47%降至1.75%（p＜0.001）。經過運用嬰幼兒輔助工具等改善計畫，除能減少嬰幼兒重照率外，亦能縮短檢查時間（45分鐘減少至2.8分鐘），並提高家屬之滿意度（71.8%至84.6%）及工作人員使用輔具後之整體滿意度（87.5%）。另開發出之輔具可有效應用於3歲以下之嬰幼兒並降低輻射所造成之風險。

關鍵字

嬰幼兒； X光攝影；重照率；輔具

並列摘要

This study aims to assess the factors affecting the need to retake in chest and abdomen X-ray of children under 3 years old in order to devise a plan for reducing the retake rate and avoid unnecessary X-ray exposure on children.We developed assistive devices that might help reduce body movement in young children during X-ray radiography.The use of stickers, small toys, fancy lead clothes and cartoon music helped soothe the children's emotions. Furthermore, we created an environment that the children liked and educated their family about how to restrain their children's body in order to ensure an effective and safe take of an X-ray radiograph. Retake rates due to blurred images, out of position images and artifact images decreased from 2.79% to 0.75% (drop 72.98 %, p＜0.001), 2.06% to 0.34% (drop 83.70%, p＜0.001) and 0.88% to 0.42% (drop 52.47%, p＞0.05), respectively. Overall retake rate was decreased from 6.47% to 1.75% (p＜0.001). Using assistive devices to help restrain of infants' and children's body can effectively reduce the retake rate of chest and abdomen X-ray radiographs. In addition, these devices can also shorten examination time (reduced from 4.5 minutes to 2.8 minutes), and improve family satisfaction (71.8% to 84.6%) as well as overall satisfaction (87.5%). These assistive devices can be effectively used with children under three years old and reduce risk of stochastic effects by radiation.

並列關鍵字

Infant ； X-ray radiography ； Retake rate ； Assistive device

參考文獻

李思穎、莊家瑜、陳沛瑀、李芳朋、王傑進、劉志浩：降低常規X光攝影重照率。 http://www.areahp.org.tw/upload/result_issue_paper/101B0051.pdf。引用7/1/2012

Google Scholar

林智勝：一般X光攝影重照的影響因素之探討。http://ir.cmu.edu.tw/ir.handle.310903500/41420。引用08/01/2013

Google Scholar

陳俊龍、陳俊傑、林德彥：頭頸部輔具使用在孩童胸腔攝影之應用■中華放射線技術學雜誌2011 ； 35 :70-5

Google Scholar

龔永權、姜義成：應用三角海綿塾輔具照射肩關節軸位攝影之技術與探討。中華放射線技術學雜誌2010 34: 135-42

Google Scholar

Hintenlang KM, Williams JL, Hintenlang DE: A survey of radiation dose associated with pediatric plain-film chest X-ray examinations. Pediatr Radiol 2002;32:771-7

Google Scholar

國際替代計量

降低嬰幼兒胸腹部x光攝影之重照率

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