Circ:Cardiovasc Inte:先天性心脏病心脏导管手术辐射暴露的纵向改善

2020-05-24 xiangting MedSci原创

使用有针对性的QI方法和干预措施可以大幅地降低辐射剂量。

2015年启动的多中心注册登记C3PO-QI(先天性心脏导管手术项目-结局质量改善)是一项质量改善(QI)计划,旨在减少患者的辐射暴露。该计划通过定期合作,使活跃的参与者之间保持和谐,从而最大程度地提高效率,实现减少辐射的最佳实践。这项研究试图以详细的方法报告这些努力,机构可以以此为目标来采取行动,减少辐射暴露并提高患者的安全性。

由8个C3PO-QI机构前瞻性收集2015年1月1日至2017年12月31日间的数据。以单位体重的剂量面积乘积测量辐射暴露(剂量面积乘/kg;µGy*m2/kg),并按预期辐射暴露类别(REC)和机构40种已发布的单独手术类型进行报告。在C3PO-QI机构的儿科导管实验室中,实施了减少选定区域辐射的干预措施。

该研究纳入15257个病例。所有手术的中位暴露(剂量面积乘积/kg)均降低了30%。全部三种REC的剂量面积乘积/kg均降低了,其中REC I的改善最大(REC I,-37%;REC II,-23%;REC III,-27%)。尽管全部C3PO-QI机构间的基线辐射暴露量和确切下降的百分比都不同,但是每个机构的辐射剂量均随着时间推移有所改善。这些改善是通过参与C3PO-QI多中心协作而加快实施的机构特异性QI干预措施实现的。

使用有针对性的QI方法和干预措施可以大幅地降低辐射剂量。由于机构的参与度提高和共享学习,加入多中心QI协作加速了所有中心的改善。

原始出处:

Brian P. Quinn. Longitudinal Improvements in Radiation Exposure in Cardiac Catheterization for Congenital Heart Disease. Circ: Cardiovascular Interventions. 15 May 2020.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1939061, encodeId=6505193906150, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Fri Jan 01 02:15:23 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2055298, encodeId=83ee20552983c, content=<a href='/topic/show?id=7b0993e442c' target=_blank style='color:#2F92EE;'>#辐射暴露#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93744, encryptionId=7b0993e442c, topicName=辐射暴露)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTI5V6pBDhhleaA9ZQaNgImyx09qqFom6WIvSGdUoWfKiaWCiaeUfnXMRECAMPA81Wkd4EOicrPibOTudQ/132, createdBy=b9382500209, createdName=ms6127405442416114, createdTime=Wed Nov 18 10:15:23 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1975671, encodeId=730619e567127, content=<a href='/topic/show?id=8dbe5148899' target=_blank style='color:#2F92EE;'>#心脏导管手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51488, encryptionId=8dbe5148899, topicName=心脏导管手术)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=fengyqf, createdTime=Thu Mar 25 23:15:23 CST 2021, time=2021-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349392, encodeId=cea613493927b, content=<a href='/topic/show?id=838593e35b2' target=_blank style='color:#2F92EE;'>#辐射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93735, encryptionId=838593e35b2, topicName=辐射)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8e4c53, createdName=jiyangfei, createdTime=Tue May 26 06:15:23 CST 2020, time=2020-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1369503, encodeId=a9431369503a5, content=<a href='/topic/show?id=bc9f28589d0' target=_blank style='color:#2F92EE;'>#先天性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28589, encryptionId=bc9f28589d0, topicName=先天性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a435298, createdName=huirong, createdTime=Tue May 26 06:15:23 CST 2020, time=2020-05-26, status=1, ipAttribution=)]
    2021-01-01 quxin068
  2. [GetPortalCommentsPageByObjectIdResponse(id=1939061, encodeId=6505193906150, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Fri Jan 01 02:15:23 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2055298, encodeId=83ee20552983c, content=<a href='/topic/show?id=7b0993e442c' target=_blank style='color:#2F92EE;'>#辐射暴露#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93744, encryptionId=7b0993e442c, topicName=辐射暴露)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTI5V6pBDhhleaA9ZQaNgImyx09qqFom6WIvSGdUoWfKiaWCiaeUfnXMRECAMPA81Wkd4EOicrPibOTudQ/132, createdBy=b9382500209, createdName=ms6127405442416114, createdTime=Wed Nov 18 10:15:23 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1975671, encodeId=730619e567127, content=<a href='/topic/show?id=8dbe5148899' target=_blank style='color:#2F92EE;'>#心脏导管手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51488, encryptionId=8dbe5148899, topicName=心脏导管手术)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=fengyqf, createdTime=Thu Mar 25 23:15:23 CST 2021, time=2021-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349392, encodeId=cea613493927b, content=<a href='/topic/show?id=838593e35b2' target=_blank style='color:#2F92EE;'>#辐射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93735, encryptionId=838593e35b2, topicName=辐射)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8e4c53, createdName=jiyangfei, createdTime=Tue May 26 06:15:23 CST 2020, time=2020-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1369503, encodeId=a9431369503a5, content=<a href='/topic/show?id=bc9f28589d0' target=_blank style='color:#2F92EE;'>#先天性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28589, encryptionId=bc9f28589d0, topicName=先天性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a435298, createdName=huirong, createdTime=Tue May 26 06:15:23 CST 2020, time=2020-05-26, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1939061, encodeId=6505193906150, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Fri Jan 01 02:15:23 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2055298, encodeId=83ee20552983c, content=<a href='/topic/show?id=7b0993e442c' target=_blank style='color:#2F92EE;'>#辐射暴露#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93744, encryptionId=7b0993e442c, topicName=辐射暴露)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTI5V6pBDhhleaA9ZQaNgImyx09qqFom6WIvSGdUoWfKiaWCiaeUfnXMRECAMPA81Wkd4EOicrPibOTudQ/132, createdBy=b9382500209, createdName=ms6127405442416114, createdTime=Wed Nov 18 10:15:23 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1975671, encodeId=730619e567127, content=<a href='/topic/show?id=8dbe5148899' target=_blank style='color:#2F92EE;'>#心脏导管手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51488, encryptionId=8dbe5148899, topicName=心脏导管手术)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=fengyqf, createdTime=Thu Mar 25 23:15:23 CST 2021, time=2021-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349392, encodeId=cea613493927b, content=<a href='/topic/show?id=838593e35b2' target=_blank style='color:#2F92EE;'>#辐射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93735, encryptionId=838593e35b2, topicName=辐射)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8e4c53, createdName=jiyangfei, createdTime=Tue May 26 06:15:23 CST 2020, time=2020-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1369503, encodeId=a9431369503a5, content=<a href='/topic/show?id=bc9f28589d0' target=_blank style='color:#2F92EE;'>#先天性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28589, encryptionId=bc9f28589d0, topicName=先天性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a435298, createdName=huirong, createdTime=Tue May 26 06:15:23 CST 2020, time=2020-05-26, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1939061, encodeId=6505193906150, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Fri Jan 01 02:15:23 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2055298, encodeId=83ee20552983c, content=<a href='/topic/show?id=7b0993e442c' target=_blank style='color:#2F92EE;'>#辐射暴露#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93744, encryptionId=7b0993e442c, topicName=辐射暴露)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTI5V6pBDhhleaA9ZQaNgImyx09qqFom6WIvSGdUoWfKiaWCiaeUfnXMRECAMPA81Wkd4EOicrPibOTudQ/132, createdBy=b9382500209, createdName=ms6127405442416114, createdTime=Wed Nov 18 10:15:23 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1975671, encodeId=730619e567127, content=<a href='/topic/show?id=8dbe5148899' target=_blank style='color:#2F92EE;'>#心脏导管手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51488, encryptionId=8dbe5148899, topicName=心脏导管手术)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=fengyqf, createdTime=Thu Mar 25 23:15:23 CST 2021, time=2021-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349392, encodeId=cea613493927b, content=<a href='/topic/show?id=838593e35b2' target=_blank style='color:#2F92EE;'>#辐射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93735, encryptionId=838593e35b2, topicName=辐射)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8e4c53, createdName=jiyangfei, createdTime=Tue May 26 06:15:23 CST 2020, time=2020-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1369503, encodeId=a9431369503a5, content=<a href='/topic/show?id=bc9f28589d0' target=_blank style='color:#2F92EE;'>#先天性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28589, encryptionId=bc9f28589d0, topicName=先天性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a435298, createdName=huirong, createdTime=Tue May 26 06:15:23 CST 2020, time=2020-05-26, status=1, ipAttribution=)]
    2020-05-26 jiyangfei
  5. [GetPortalCommentsPageByObjectIdResponse(id=1939061, encodeId=6505193906150, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Fri Jan 01 02:15:23 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2055298, encodeId=83ee20552983c, content=<a href='/topic/show?id=7b0993e442c' target=_blank style='color:#2F92EE;'>#辐射暴露#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93744, encryptionId=7b0993e442c, topicName=辐射暴露)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTI5V6pBDhhleaA9ZQaNgImyx09qqFom6WIvSGdUoWfKiaWCiaeUfnXMRECAMPA81Wkd4EOicrPibOTudQ/132, createdBy=b9382500209, createdName=ms6127405442416114, createdTime=Wed Nov 18 10:15:23 CST 2020, time=2020-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1975671, encodeId=730619e567127, content=<a href='/topic/show?id=8dbe5148899' target=_blank style='color:#2F92EE;'>#心脏导管手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51488, encryptionId=8dbe5148899, topicName=心脏导管手术)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=fengyqf, createdTime=Thu Mar 25 23:15:23 CST 2021, time=2021-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349392, encodeId=cea613493927b, content=<a href='/topic/show?id=838593e35b2' target=_blank style='color:#2F92EE;'>#辐射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93735, encryptionId=838593e35b2, topicName=辐射)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8e4c53, createdName=jiyangfei, createdTime=Tue May 26 06:15:23 CST 2020, time=2020-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1369503, encodeId=a9431369503a5, content=<a href='/topic/show?id=bc9f28589d0' target=_blank style='color:#2F92EE;'>#先天性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28589, encryptionId=bc9f28589d0, topicName=先天性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a435298, createdName=huirong, createdTime=Tue May 26 06:15:23 CST 2020, time=2020-05-26, status=1, ipAttribution=)]
    2020-05-26 huirong

相关资讯

15岁少年,体检发现心脏杂音半年。

15岁少年,体检发现心脏杂音半年。

Congenit Heart Dis:法舒地尔可以改善CHD-PAH患者的血流动力学,特别是60-mg剂量

在伴有严重肺动脉高压(CHD-PAH)的先天性心脏病患者中,法舒地尔的最佳剂量仍有争议。本研究旨在对比伴重症肺动脉高压的先天性心脏病成人患者中不同剂量的法舒地尔治疗后的急性血流动力学变化。

JAHA:环境和社会经济因素影响先天性心脏病的发病率

社会剥夺增加和环境污染物暴露与加州活产婴儿CHD的发病率相关。

Heart:成人先天性心脏病心脏导管介入的复杂性和安全性结局

这项研究表明,ACHD导管介入治疗的复杂性不断增加,病种不断扩大,而这与主要并发症的发生率低、住院时间短和早中期死亡率低相关。

JAHA:先天性心脏病手术后的慢性疾病负担

无论心脏病的严重程度如何,CHS后的慢性心脏和非心脏后遗症都很常见。

Pulm Circ:血清生存素代表了反映CHD-PAH患者可操作性的候选生物标志物

肺动脉高压(PAH)的可逆性决定了先天性心脏病(CHD)合并PAH的治疗难易性,但缺乏评价可逆性的方法。本研究旨在研究不可逆PAH大鼠血清生存素水平,探讨其作为评估CHD患者PAH可逆性的生物标志物的