【摘要】 目的 分析镇江市医疗机构放射工作人员职业性外照射个人剂量水平，为镇江市医疗机构放射防护管理提供参考依据，保护放射工作人员健康。方法 2019—2023年依据GBZ 128—2019《职业性外照射个人监测规范》，采用热释光剂量测读系统对放射工作人员开展外照射个人剂量监测，每年监测满4次的放射工作人员纳入研究，分析不同年份、职业类别和等级医院的放射工作人员年有效剂量监测结果，并对异常剂量产生的原因进行分析。结果 共收集4 900人个人剂量监测结果，监测人数逐年增多，总连续性监测率为80.9%。放射工作人员人均年有效剂量值中位数为0.84 mSv。70.3%的放射工作人员年有效剂量值<1.0 mSv。不同年份人均年有效剂量值差异有统计学意义（H=342.267,P<0.01）,2022和2023年的人均年有效剂量值低于2019、2020、2021年（均P<0.05）,2021年的人均年有效剂量值低于2019、2020年（均P<0.05）。不同职业类别的放射工作人员人均年有效剂量值比较差异有统计学意义（H=99.583,P<0.01）。介入放射学放射工作人员人均年有效剂量值中位数低于诊断放射和牙科放射学（均P<0.05），其余职业类别比较差异无统计学意义。不同等级医院人均年有效剂量值中位数比较差异有统计学意义（H=32.980,P<0.01），二级医院放射工作人员人均年有效剂量值低于三级医院和一级及未定级医院，差异有统计学意义（P<0.05）。2019—2023年单个监测周期剂量≥1.25 mSv共有457人次，占总监测人次数的2.10%。有71人次监测剂量>5 mSv，异常剂量产生的原因主要是个人剂量计误置于照射范围内（48.8%）。结论 2017—2019年镇江市医疗机构放射工作人员外照射个人剂量监测值远低于国家标准。应当继续加强监管，规范个人剂量佩戴标准，加强连续性监测。在放射卫生管理中要更加关注基层卫生机构，以保障放射工作人员健康。更多还原

【Abstract】 Objective To analyze the individual dose level of occupational external radiation of radiation workers in medical institutions in Zhenjiang City,provide a reference for the radiation protection management of medical institutions in Zhenjiang City and protect the health of radiation workers. Methods According to the GBZ 128-2019 Code for Personal Monitoring of Occupational External Radiation,the thermoluminescence dosimetry system was used to monitor the personal dose of external radiation to radiation workers. The radiation workers who were monitored four times a year were included in the study,the annual effective dose monitoring results of radiation workers in different years,occupational categories and levels of hospitals were analyzed,and the causes of abnormal dose were analyzed. Results A total of 4 900 individuals were collected for dose monitoring,and the number of people monitored increased year by year,with a total continuous monitoring rate of 80.9%. The median annual effective dose per capita of radiation workers was 0.84 mSv. 70.3% of radiologists had an annual effective dose <1.0 mSv. There was statistically significant difference in the per capita annual effective dose among different years(H=342.267,P<0.01),the per capita annual effective dose in 2022 and 2023 was lower than that in 2019,2020,and 2021(all P<0.05),and the per capita annual effective dose in 2021 was lower than that in 2019 and 2020(all P<0.05). There was statistically significant difference in the per capita annual effective dose among radiation workers in different occupational groups(H=99.583,P<0.01). The median annual effective dose per capita of interventional radiology workers was lower than that of diagnostic radiology and dental radiology(both P<0.05). There was no statistically significant difference among other occupational groups. There was a statistically significant difference in the median per capita annual effective dose value among different levels of hospitals(H=32.980,P<0.01),and the per capita annual effective dose value of radiation workers in secondary hospitals was lower than that of tertiary hospitals and primary and ungraded hospitals,with statistically significant difference(P<0.05). From 2019 to 2023,a total of 457 people had ≥1.25 mSv in a single monitoring cycle,accounting for 2.10% of the total number of monitoring person-times. There were 71 cases in which the monitored dose >5 m Sv,and the abnormal dose was mainly due to the personal dosimeter being misplaced in the irradiation range(48.8%).Conclusions From 2017 to 2019,the monitoring value of external radiation dose of radiation workers in medical institutions in Zhenjiang City is far lower than the national standard. It is necessary to continue to strengthen supervision,standardize personal dosage wearing standards,and enhance continuous monitoring. More attention should be paid to grassroots health institutions in radiation health management to ensure the health of radiation workers.更多还原