【摘要】 目的 分析1例行钇-90微球选择性内放射治疗(⁹⁰Y-SIRT)的肝细胞癌患者在治疗过程中的外照射剂量率与放射防护措施。方法 采用回顾性分析方法，选择1例接受活度为4.65×10⁹ Bq的⁹⁰Y-SIRT的肝细胞癌男性患者为研究对象。采用外照射剂量率仪分别检测治疗时放射工作人员、患者和工作场所的周围剂量当量率；采用表面污染仪检测放射工作人员和工作场所的表面污染水平。结果 治疗时介入放射学工作人员周围剂量当量率为3.7～39.0μSv/h。患者术后0.0～161.0 h在距手术部位30、100和200 cm处的周围剂量当量率，在手术部位无防护时为45.0～5.6、4.4～0.4、0.4～0.1μSv/h；在手术部位覆盖1.0 mmPb铅橡胶方巾时为14.0～3.4、3.2～0.3、0.4～0.1μSv/h。核医学科工作场所周围剂量当量率为0.4～740.0μSv/h；数字减影血管造影设备手术室各检测点周围剂量当量率均为0.1μSv/h；留观病房周围剂量当量率为0.1～0.2μSv/h。放射工作人员和工作场所的β表面污染水平均低于最小探测下限（0.16 Bq/cm²）。结论 术后肝细胞癌患者和放射工作人员使用合适的防护装备后，其辐射剂量水平处于可接受范围；工作场所应合理布局，确保放射防护措施的有效实施。更多还原

【Abstract】 Objective To analyze the external radiation dose rate and radiation protection measures during treatment of a patient with hepatocellular carcinoma（HCC） who underwent ⁹⁰Y selective internal radiotherapy(⁹⁰Y-SIRT). Methods A male HCC patient who received ⁹⁰Y-SIRT with an activity of 4.65×10⁹ Bq was selected as the research subject using retrospective analysis. External radiation dose rate meters were used to detect ambient dose equivalent rates around the radiation worker, the HCC patient, and the workplace during treatment. Surface contamination meters were used to detect surface contamination levels of the radiation worker and the workplace. Results The ambient dose equivalent rate around the interventional radiology staff during treatment ranged from 3.7 to 39.0 μSv/h. The patient′s ambient dose equivalent rate of surgical site at distances of 30, 100, and 200 cm ranged from 45.0 to 5.6, 4.4 to 0.4, and 0.4 to 0.1 μSv/h respectively without protection, and 14.0 to 3.4, 3.2 to 0.3, and 0.4 to 0.1 μSv/h respectively when the surgical site was covered with a 1.0 mmPb lead rubber drape after 0.0 to 161.0 hours of the surgery. In the nuclear medicine department, ambient dose equivalent rate of the workplace ranged from 0.4to 740.0 μSv/h. The ambient dose equivalent rate around all monitoring points in the digital subtraction angiography operating room accounted at 0.1 μSv/h, and the observation ward ranged from 0.1 to 0.2 μSv/h. The β surface contamination levels of the radiation worker and workplace were below the minimum detection limit（0.16 Bq/cm²）. Conclusion Radiation doses for both HCC patients and radiation worker remained within acceptable limits when appropriate protective equipment was used. A welldesigned workplace layout is essential to ensure effective implementation of radiation protection.更多还原