利用全民健保資料庫研究懷孕婦女接受輻射曝露對胎兒的影響

Effects on the fetus：Using National Health Insurance Research Database for pregnant women received radiation exposure

游和祥(Her-Shiang Yu)

指導教授 ： 鍾相彬

高雄醫學大學/健康科學院/醫學影像暨放射科學系碩士在職專班/碩士(2016年)

摘要

部分孕婦接受放射線檢查時，並不知道自己是懷孕初期。有些是因為重大原因或是車禍，到醫院必須要照X光而接受輻射。當她們知道懷孕接受放射線檢查會影響胎兒健康。有部分的人會因此一直煩惱著胎兒的風險，另一部分的人會過於擔心而去終止懷孕。其實這問題是我們應該去面對的。這些接受X光照射的孕婦，如果可以評估接受到的劑量。可以在事前降低其放射線劑量並評估所造成的輻射風險。
利用2008-2010年健保資料庫百萬歸人檔，剔除多胞胎及沒有產檢紀錄之產婦，取得總產婦共14,133人次。去比較懷孕期間接受放射線檢查產婦（1,101人次）與懷孕期間沒有接受放射線檢查產婦（13,032人次）於新生兒出生異常指標狀況。將懷孕婦女分為是否接受放射線檢查兩個族群，以早產（懷孕週數少於37週）及體重不足（小於2,500g）為研究變項，使用卡方檢定與羅吉斯迴歸去分析關聯性與勝算比。
研究結果顯示新生兒早產與接受放射線檢查具有顯著關聯性。懷孕期間接受放射線檢查的產婦所分娩的新生兒是懷孕期間沒有接受放射線檢查的產婦所分娩的新生兒發生早產的0.751倍。新生兒體重不足與接受放射線檢查不具顯著關聯性。
本研究推論，懷孕期間接受放射線檢查不會增加早產的風險，但不代表可以無上限的接受放射線檢查。在臨床上對於女性患者，不確定是否懷孕可能前，應將放射線檢查視為第三線工具，以超音波和核磁共振為主。

關鍵字

健保資料庫 ； 懷孕 ； 輻射傷害

並列摘要

Some pregnant women when receiving radiation inspection, do not know they was pregnant. Some major reasons is because of a car accident, to the hospital for X-rays and must be exposed to radiation. When they know that pregnancy to accept radiography will affect fetal health, some people will therefore have to worry about the risk of the fetus, another part of the people will worry too much then termination of pregnancy. In fact, this problem is that we should go to face. These pregnant women accepted X rays, if you can assess the dose received, you can also reduce the risk beforehand radiation and to assess the radiation dose caused in.
Use 2008-2010 National Health Insurance database owned by one million people file, excluding multiple births and there is no record of the women giving birth, a total of 14,133 pregnant woman. During the inspection to compare pregnant women receiving radiation (1,101 people) and during pregnancy did not receive radiation inspection maternal (13,032 people) in newborns abnormal performance indicator. The pregnant women are divided into two groups to accept radiography to preterm birth (less than 37 weeks gestational age) and underweight (less than 2,500g) to study the variables, using chi-square test and logistic regression to analyze the relevance and risk ratio.
The results showed that accepted radiography has significant relevance in newborns and preterm. Pregnancy women accepted radiography than not accepted radiography had preterm birth is 0.751 times. Low birth weight and accepted radiography non-significant correlation.
This study inferred receiving radiographs does not increase the risk of premature during pregnancy, but it does not mean that you can accept unlimited radiographs. For female patients in the clinic, uncertain whether the possibility of pregnancy, radiography should be treated as third tools with ultrasound and MRI.

並列關鍵字

National health insurance research database ； Pregnancy ； Fetus ； Radiation damage

參考文獻

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