【作者】 周群；

【导师】 涂彧；

【作者基本信息】 苏州大学 ， 公共卫生（专业学位）， 2017， 硕士

【摘要】 [目的]了解2017年县区级放射诊疗防护管理的现状,掌握放射防护管理中存在的问题和困难,通过对三个省内六个县区的放射诊疗单位放射防护管理和防护情况的调查与分析,探究其影响因素,为进一步加强县区级放射诊疗单位的放射诊疗防护管理工作,规范其放射防护行为和提高县区级放射防护水平提供对策和依据。[方法]以无锡市梁溪区、南通市海安县,张家界慈利县、湘西花垣县、郑州市二七区、开封市新区六个县区级地区为调查对象,采用普查的方法,对六个县区2017年放射诊疗单位的放射防护管理情况,放射诊疗设备的种类和防护用品配备情况、放射诊疗许可情况、放射诊疗建设项目、放射诊疗场所防护管理情况,放射工作人员的职业健康监护情况等情况进行调查。专人负责用Epidata3.0进行数据录入,严格数据核对、逻辑检查以及异常值的判断和处理。调查数据采用SPSS13.0软件进行统计学分析,率间比较采用x2检验。以P<0.05为差异有统计学意义。[结果]分布基本情况本研究共调查六个县区内2017年正式许可的放射单位共285家,其中无锡市梁溪区有99家,南通市海安县有55家,郑州市二七区64家、开封市新区23家、张家界慈利县23家、湘西花垣县21家。放射基本情况2017年各级各地区放射诊疗机构的《放射诊疗许可证》校验情况,285家放射诊疗机构总的校验率为92.3%,放射防护用品配备合格率总的合格率为85.8%,六个县区《放射诊疗许可证》校验率和放射防护用品配备合格率存在差异,梁溪区、海安县、二七区、开封新区要好于慈利县、花垣县。机房尺寸总的合格率为93.7%,无明显差异。《放射诊疗许可证》2017年二级以下放射诊疗机构的《放射诊疗许可证》校验率较低,放射防护用品的配备合格率也较低。基层医院的机房尺寸合格率较低。三个省的放射诊疗机构按规定校验率湖南省两个县区的《放射诊疗许可证》按规定校验率较低。放射防护用品配备率湖南省两个县区的放射用品配备合格率较低。机房尺寸合格率三个省无明显差异。公立医院的《放射诊疗许可证》按规定校验率较民营医院校验率高。公立医院的放射用品配备情况较民营医院好。机房尺寸合格率民营医院的情况较公立医院好。放射诊疗设备情况此次调查的放射诊疗机构共有放射诊疗设备375台,其中普通X射线机170台(透视机、屏片摄影机、胃肠机、移动x线机)、CT有19台,CR\DR有77台,牙科X射线机有93台,乳腺X射线机有8台、其他8台(DSA、LA)。放射防护管理情况六个县区放射诊疗机构都开展了放射防护管理工作,无锡市梁溪区、南通市海安县较郑州市二七区、开封市新区好,张家界慈利县和湘西花垣县的放射防护管理情况较其他四个地区差。三级医院和二级医院的放射防护设备和场所管理情况都比较好,一级及未定级医疗机构做的较差。江苏省和河南省放射防护设备和场所管理情况较湖南省好。放射工作人员情况2017六个县区放射诊疗单位放射工作人员情况各个指标梁溪区、海安县、二七区、开封新区情况较慈利县、花垣县好。射诊疗单位放射工作人员情况各个指标不合格的主要集中在一级医院和未定级医院。江苏省和河南省的放射工作人员情况各个指标合格率较湖南省好。公立医院的放射工作人员情况各个指标合格率较民营医院好。[结论]各区和各级放射诊疗防护都有待规范,放射防护管理水平有待提高。安全防护装置、个人放射防护用品的使用等方面需要进一步完善和改进。各级放射诊疗单位放射防护总体水平不高,由其以一级和未定级的医疗机构为突出。部分医疗机构尤其是边远地区和二级以下放射诊疗机构对放射诊疗防护的重视程度不够、经费投入不足,卫生监管部门对放射诊疗的违法行为查处力度也不够,加上患者和受检者防护意识不强,是各区各放射诊疗机构放射诊疗防护规范化管理面临的主要问题和困难。更多还原

【Abstract】 objective to understand county district 2017 radiological diagnosis and protection management present situation,grasp the problems and difficulties existing in radiological protection management,through the three units of six counties in the province of radiological diagnosis and treatment on radiological protection management and protection of investigation and analysis,to explore the influence factors,in order to further strengthen the county district the radiological diagnosis and protection management of radiological diagnosis and treatment unit,regulating the behavior of the radiological protection and improve the level of county district on radiological protection to provide countermeasures and basis.[methods]to wuxi Liang Xi in nantong area,haian county,zhangjiajie cili county,west slope,erqi district,zhengzhou city,kaifeng district six counties district areas as investigation object,and using the method of census of radiological diagnosis and six counties and 2017 units of radiological protection management situation,the types of radiation therapy equipment and protective equipment equipped with permission,radiological diagnosis and treatment situation,radiation therapy,radiological diagnosis and place protection management of construction projects,and the occupational health situation for radiation workers,and so on and so forth.The special person is responsible for using Epidata3.0 for data entry,strict data checking,logical checking and abnormal value judgment and processing.SPSS 13.0 was used for statistical analysis,and chi-2 test was used in comparison.P<0.05 was considered to be statistically significant.[results]1.Basic distributionThis study investigated the six counties in 2017 officially licensed radiation unit,a total of 285,the wuxi Liang Xi area has 99,nantong haian county has 55,64 erqi district of zhengzhou city,kaifeng district 23,zhangjiajie cili 23,xiangxi 21 through county.2.Basic information of radiation2017 regional radiation medical institutions at all levels of the radiation therapy license check situation of 285 radiation medical institutions general calibration rate was 92.3%,the radiation protective equipment equipped with qualified rate of the total percent of pass is 85.8%,six counties and the radiation therapy license check rate and radiation protective equipment equipped with qualified rate differences,Liang Xi area,haian county,erqi district,kaifeng district better than cili,flowers through the county.The overall pass rate of machine room size was 93.7%,no obvious difference.The "radiological diagnosis and treatment license" is lower in the radiological diagnosis and treatment facility under the secondary level in 2017,and the qualified rate of radiological protection supplies is lower.The size of the machine room in the primary hospital is low.The radiological diagnosis and treatment institutions of the three provinces have a low calibration rate according to the provisions of the "radiological diagnosis and treatment license" of two counties in hunan province.The radiological protective equipment has a low qualified rate in two counties in hunan province.There is no obvious difference in the size of machine room.The radiological diagnosis and treatment license of public hospitals is higher than that of private hospitals.Radiation supplies in public hospitals are better than private hospitals.The situation of the private hospital is better than that of public hospitals.3.Radiological diagnosis and treatment equipmentThe survey of radiation medical institutions a total of 375 sets of radiation therapy equipment,including ordinary X-ray machine 170 units(X-ray machine,screen camera,gastrointestinal machine,mobile X-ray machine),computed tomography(CT)19,CR/DR has 77 units,93 dental X-ray machines,eight breast X-ray machines and other 8(DSA),LA.4.Radiation protection managementSix counties are conducted on radiological protection management of radiological diagnosis and treatment work,wuxi Liang Xi nantong haian county area,the more erqi district of zhengzhou city,kaifeng district is good,zhangjiajie cili county and xiangxi through radiological protection management of the county of poor than other four areas.The radiological protection equipment and site management of tertiary hospitals and secondary hospitals are better,and the level of the primary and undetermined medical institutions is worse.The radiation protection equipment and site management in jiangsu province and henan province are better than hunan province.5.The situation of radiological personnelThe radiological staff of the six counties in the county area of 2017,the conditions of the radiology and treatment unit of the six counties,the liang xi district,haian county,erqi district and kaifeng new district are better than cili county and hua yuan county.All indicators of radiological staff of radiological treatment unit are mainly concentrated in first-class hospitals and unrated hospitals.In jiangsu province and in henan province,the rate of radiation work is better than in hunan province.The radiological staff of km hospital are better than private hospitals.[conclusion]radiation and treatment protection at all levels and at all levels need to be standardized,and the level of radiological protection management needs to be improved.Safety protection devices and the use of personal radiological protection products need to be further improved and improved.The radiation protection units at all levels are not high in radiation protection,and they are highlighted by the primary and undetermined medical institutions.Part especially in remote areas and medical institutions under the secondary radiation medical institutions of radiological diagnosis and protection,not enough emphasis,inadequate funding,health authorities of radiological diagnosis and treatment of illegal investigation dynamics is insufficient,add patients and subjects protection consciousness is not strong,the division radiological diagnosis and treatment institutions radiological diagnosis and protection of the main problems in the standardization management and difficulties.更多还原