Cov koob tshuaj hluav taws xob uas ib tus neeg tau txais thaum lub sijhawm kho mob, raws li ntau yam kev kwv yees, nyob ntawm 20 txog 30% ntawm tag nrho cov hluav taws xob tom qab. Cov hluav taws xob hluav taws xob ib txwm muaj nyob hauv ib puag ncig - tib neeg tau txais los ntawm lub hnub, los ntawm lub plab hnyuv hauv ntiaj teb, los ntawm radionuclides uas nyob hauv dej thiab hauv ntiaj teb. "Kev kho mob" hluav taws xob yog nyob rau hauv qhov chaw thib ob ntawm qhov tseem ceeb ntawm txhua yam ntawm qhov chaw, ua ntej ntawm tib neeg tsim hluav taws xob (los ntawm cov chaw tsim hluav taws xob nuclear, cov chaw pov tseg hluav taws xob, cov khoom siv hauv tsev, xov tooj ntawm tes). Cia peb sim saib seb qhov koob tshuaj hluav taws xob suav li cas rau x-rays thiab nws txaus ntshai npaum li cas.
X-rays
Raws li cov kws tshawb fawb, koj yuav tsum tsis txhob ntshai ntawm lub ntuj tsim hluav taws xob. Tsis tas li ntawd, nws pab txoj kev loj hlob thiab kev loj hlob ntawm tag nrho cov kab mob nyob hauv lub ntiaj teb. Txhua xyoo ib tug neeg tau txais ib koob tshuaj hluav taws xob sib npaug ntawm 0.7-1.5 mSv. Kev nthuav tawm uas tib neeg raug pom los ntawm kev kuaj X-ray, qhov nruab nrab, yuav luag tib tus nqi - txog 1.2-1.5 mSv ib xyoos. Yog li, anthropogenic tivthaivmuab ob npaug rau qhov koob tshuaj tau txais.
X-ray diagnostic technologies yog dav siv los kuaj ntau yam kab mob. Txawm tias muaj tseeb hais tias nyob rau hauv xyoo tas los no tau muaj kev loj hlob ntawm lwm yam technologies nyob rau hauv cov tshuaj (xws li tomography, MRI, ultrasound, thermal imaging), ntau tshaj li ib nrab ntawm cov kev kuaj mob yog tsim los ntawm X-rays.
Thaum pib ntawm lub xyoo pua 21st, yuav luag txhua qhov kev ua tau zoo rau kev txo qis tshaj plaws ntawm cov hluav taws xob hauv kev kuaj X-ray kuj tau tag nrho. Txoj kev ua tau zoo tshaj plaws hauv qhov no tau dhau los ua cov txheej txheem digital rau hloov cov duab x-ray. Lub tshuab kuaj pom ntawm lub tshuab X-ray muaj qhov rhiab heev uas yog ob peb zaug siab dua li cov yeeb yaj kiab, uas ua rau nws muaj peev xwm txo tau cov tshuaj tawg.
ntsuas ntsuas
Tsis zoo li cov hluav taws xob keeb kwm yav dhau los, hluav taws xob raug hauv kev tshawb fawb kho mob tsis sib xws. Txhawm rau txiav txim siab qhov kev puas tsuaj uas X-rays ua rau tib neeg, koj yuav tsum xub xyuas seb qhov ntsuas hluav taws xob tau ntsuas li cas.
Kom ntsuas cov txiaj ntsig ntawm ionizing hluav taws xob hauv kev tshawb fawb, tus nqi tshwj xeeb tau qhia - qhov sib npaug ntawm koob H. Nws yuav siv sij hawm rau hauv tus account cov yam ntxwv ntawm hluav taws xob raug siv qhov hnyav. Nws tus nqi txhais tau tias yog cov khoom ntawm cov tshuaj absorbed hauv lub cev los ntawm qhov hnyav coefficient W R, uas nyob ntawm hom hluav taws xob (α, β, γ). Cov koob tshuaj absorbed yog xam raws li qhov piv ntawm tus nqiionizing zog hloov mus rau cov khoom, mus rau qhov loj ntawm cov khoom nyob rau hauv tib lub ntim. Nws ntsuas hauv Greys (Gy).
Qhov tshwm sim ntawm qhov tsis zoo yog nyob ntawm lub xov tooj cua ntawm cov ntaub so ntswg. Rau qhov no, lub tswv yim ntawm kev siv tshuaj zoo tau qhia, uas yog qhov sib npaug ntawm cov khoom ntawm H hauv cov ntaub so ntswg thiab qhov hnyav coefficient Wt. Nws tus nqi nyob ntawm seb lub cev puas raug cuam tshuam. Yog li, nrog x-ray ntawm txoj hlab pas, nws yog 0.05, thiab nrog irradiation ntawm lub ntsws - 0.12. Cov koob tshuaj zoo yog ntsuas hauv Sieverts (Sv). 1 Sievert sib raug rau cov tshuaj nqus hluav taws xob uas qhov hnyav yog 1. Qhov no yog tus nqi loj heev, yog li millisieverts (mSv) thiab microsieverts (µSv) yog siv hauv kev xyaum.
Kev puas tsuaj
Qhov teeb meem ntawm hluav taws xob rau tib neeg kev noj qab haus huv nyob ntawm qib koob tshuaj thiab ntawm lub cev uas raug. Irradiation ntawm cov pob txha pob txha ua rau cov kab mob ntshav (leukemia thiab lwm yam), thiab kis tau rau hauv qhov chaw mos ua rau cov caj ces txawv txav ntawm cov xeeb ntxwv.
Cov tshuaj tawg loj yog 1 Gy lossis ntau dua. Hauv qhov no, kev ua txhaum cai hauv qab no tshwm sim:
- kev puas tsuaj rau cov hlwb loj;
- hluav taws kub hnyiab;
- kab mob kis;
- cataracts thiab lwm yam pathologies.
Ntawm qhov koob tshuaj no, kev hloov pauv ntawm lub cev tsis muaj kev zam. Kev kis tau tuaj yeem tau txais tsis tu ncua rau ob peb teev lossis sib sau ua ntu zus raws li qhov tshwm sim ntawm ntau tshaj qhov pib tag nrho. Qhov hnyav ntawm tus kab mob nyob ntawm tus nqi ntawmkoob tshuaj.
Nrog rau nruab nrab (0.2-1 Gy) thiab qis (<0.2 Gy) koob tshuaj, kev hloov pauv ntawm tus kheej yuav tshwm sim, uas tshwm sim tom qab ib ntus, tom qab lub sijhawm latent (latent) lub sijhawm. Nws tau xav tias cov teebmeem no tuaj yeem tshwm sim ntawm cov tshuaj tiv thaiv hluav taws xob tsawg. Qhov hnyav ntawm tus kab mob hauv qhov no tsis yog nyob ntawm qhov koob tshuaj tau txais. Kev ua txhaum feem ntau tshwm sim nyob rau hauv daim ntawv ntawm cov qog nqaij hlav cancer thiab caj ces txawv txav. Malignant neoplasms tuaj yeem tshwm sim tom qab ntau xyoo lawm. Txawm li cas los xij, kev tshawb fawb qhia tias tsis pub ntau tshaj 1% ntawm cov neeg mob muaj kev pheej hmoo.
X-rays siv hom twg?
Radiation exposure yog siv nyob rau hauv cov nram qab no hom kev ntsuam xyuas:
- fluorography, uas yog dav siv los kuaj kab mob rau kev tiv thaiv;
- pab hluav taws xob;
- xam tomography;
- angiography (kev kuaj ntshav);
- radioimmunoassay.
Yuav raug hluav taws xob txiav txim li cas?
Txhua lub tshuab x-ray niaj hnub no tau nruab nrog lub ntsuas ntsuas tshwj xeeb uas txiav txim siab cov koob tshuaj hluav taws xob zoo, suav nrog thaj tsam ntawm qhov raug. Built-in dosimeters yog siv los ua tus ntes.
Yog tias cov cuab yeej qub qub uas tsis tau nruab nrog lub ntsuas hluav taws xob siv rau kev kuaj xyuas, tom qab ntawd cov hluav taws xob tawm hluav taws xob txiav txim siab siv qhov chaw kho mob dosimeters ntawm qhov deb ntawm 1 m ntawm qhov tsomradiant tube nyob rau hauv hom kev khiav hauj lwm.
Irradiation register
Raws li SanPiN 2.6.1.1192-03, tus neeg mob muaj cai muab cov ntaub ntawv tag nrho txog kev raug hluav taws xob thiab nws qhov tshwm sim, nrog rau kev txiav txim siab ntawm tus kheej ntawm kev kuaj X-ray.
Tus kws kho mob X-ray (lossis nws tus kws kuaj mob) yuav tsum sau cov koob tshuaj zoo rau ntawm daim ntawv teev koob tshuaj. Daim ntawv no tau muab tso rau hauv tus neeg mob cov ntaub ntawv kho mob sab nraud. Kev sau npe kuj tau ua nyob rau hauv cov ntawv sau npe, uas yog khaws cia hauv chav X-ray. Txawm li cas los xij, cov cai no feem ntau tsis raug hwm hauv kev coj ua. Yog vim li cas rau qhov no nyob rau hauv qhov tseeb hais tias cov hluav taws xob koob tshuaj rau X-rays yog tsawg dua qhov tseem ceeb.
Ntxhais neeg mob
Vim tias muaj hluav taws xob raug, kev kuaj X-ray tsuas yog muab rau cov lus qhia nruj. Txhua tus neeg mob tau muab faib ua 3 pawg:
- BP - cov no yog cov neeg mob uas tau xaj X-rays rau cov kab mob tsis zoo lossis qhov tsis txaus ntseeg ntawm lawv, nrog rau cov xwm txheej uas muaj cov cim tseem ceeb (piv txwv li, raug mob). Qhov siab tshaj plaws pub koob tshuaj ib xyoos twg yog 150 mSv. Qhov raug tshaj qhov nqi no yuav ua rau raug hluav taws xob raug mob.
- BD - cov neeg mob uas tau irradiated rau lub hom phiaj ntawm kev kuaj mob ntawm ib qho tsis zoo. Rau lawv, koob tshuaj yuav tsum tsis pub tshaj 15 mSv / xyoo. Yog tias nws dhau lawm, qhov kev pheej hmoo ntawm cov kab mob nyob rau lub sijhawm ntev thiab kev hloov ntawm caj ces nce zuj zus.
- VD yog ib pawg ntawm cov neeg uasKev kuaj x-ray yog ua rau kev tiv thaiv, nrog rau cov neeg ua haujlwm uas nws cov dej num cuam tshuam nrog cov xwm txheej tsis zoo (qhov siab tshaj plaws tau tso cai yog 1.5 mSv).
Irradiation doses
Cov ntaub ntawv hauv qab no muab lub tswv yim ntawm qhov kev kuaj X-ray tuaj yeem tau txais thaum kuaj:
- lub hauv siab fluorography – 0.08 mSv;
- kuaj lub mis (mammography) – 0.8 mSv;
- x-ray ntawm txoj hlab pas thiab plab - 0.046 mSv;
- X-ray ntawm cov hniav – 0.15-0.35 mSv.
Ntawm qhov nruab nrab, ib tus neeg tau txais koob tshuaj ntawm 0.11 mSv ib tus txheej txheem. Cov tshuab xoo hluav taws xob digital tuaj yeem txo cov hluav taws xob cuam tshuam hauv X-ray kuaj rau tus nqi ntawm 0.04 mSv. Rau kev sib piv, thaum ya rau 8 teev nyob rau hauv ib lub dav hlau, nws yog 0.05 mSv, thiab qhov siab dua lub davhlau qhov siab ntawm txoj kev ntev, qhov ntau dua qhov koob tshuaj no. Hauv qhov no, cov kws tsav dav hlau muaj tus qauv huv rau lub sijhawm ya davhlau - tsis pub tshaj 80 toj ib hlis.
Kuv tuaj yeem kuaj X-ray pes tsawg zaug hauv ib xyoos?
Hauv cov tshuaj, muaj qhov ntau tshaj plaws ntawm cov hluav taws xob tau txais - 1 mSv ib xyoos. Txawm li cas los xij, nws yuav tsum tau muab sau tseg tias tus nqi no yog qhia rau kev tshawb fawb tiv thaiv. Qhov no suav nrog txog 10 lub xov tooj cua thiab 20 digital fluorography. Yog tias ntau qhov kev tshawb fawb sib txawv tau ua tiav (mammography, kho hniav), ces tag nrho cov koob tshuaj txhua xyoo tuaj yeem ncav cuag 15 mSv. Hauv Tebchaws Meskas, tus nqi noj tshuaj ib txwm muaj siab dua hauv tebchaws Russia - 3 mSv.
KKev mob hluav taws xob yog tshwm sim los ntawm koob tshuaj kaum zaug ntau dua - txog 1 Sv. Ntxiv mus, qhov no yuav tsum yog hluav taws xob tau txais los ntawm ib tus neeg hauv 1 ntu. Txawm hais tias qhov sib txawv no, cov kev cai tsuas yog xav tau lub hauv siab X-ray ib xyoos ib zaug rau kev tiv thaiv.
Cov qauv no tsis siv rau cov neeg mob uas tau kuaj X-ray raug rau kev kuaj mob, txhawm rau kuaj kab mob rau kev noj qab haus huv. Hauv qhov no, lo lus nug ntawm pes tsawg zaus hauv ib xyoos X-rays tuaj yeem ua tiav tsis tau tswj hwm. Tus neeg mob tuaj yeem txhaj koob tshuaj 4 zaug hauv 1 hnub, thiab ntau qhov txhaj tshuaj txhua 1-2 lub lis piam rau 2-3 lub hlis.
MRI thiab CT
Magnetic resonance imaging - MRI - feem ntau tsis meej pem nrog x-rays. Txawm li cas los xij, hom kev ntsuam xyuas no tsis tsim muaj hluav taws xob thauj khoom. Lub hauv paus ntsiab lus ntawm cov tshuab no yog ua raws li cov khoom sib nqus ntawm cov ntaub so ntswg. Cov hydrogen protons muaj nyob rau hauv lawv tso tawm lub zog nyob rau hauv lub zog ntawm lub xov tooj cua zaus pulses. Lub zog no tau sau npe thiab ua tiav hauv daim duab hauv computer.
Hauv qhov sib piv rau MRI, suav tomography - CT - yog tus cwj pwm los ntawm qhov ntau tshaj plaws ntawm hluav taws xob. Hauv ib qho kev sib tham, koj tuaj yeem tau txais ib koob tshuaj hluav taws xob nrog X-rays ntawm qhov kev txiav txim ntawm 4-5 mSv. Qhov no yog yuav luag kaum npaug ntau dua li cov koob tshuaj los ntawm kev kuaj X-ray. Yog li ntawd, tsis muaj kev qhia tshwj xeeb, CT tsis pom zoo.
Cov menyuam puas tuaj yeem x-rays?
Vim cov me nyuam raug mob ntau duaX-rays, tom qab ntawd, raws li WHO cov lus pom zoo, nws yog txwv tsis pub ua kev tshuaj xyuas kev tiv thaiv thaum yau (txog 17 xyoo). Vim qhov siab me thiab qhov hnyav, tus me nyuam tau txais hluav taws xob ntau dua.
Txawm li cas los xij, rau kev kho mob lossis kuaj mob, X-ray tseem ua rau menyuam yaus. Qhov no siv rau cov xwm txheej no thaum tus menyuam raug mob (pob txha, dislocations), nrog pathologies ntawm lub paj hlwb, plab hnyuv, nrog xav tias mob ntsws, noj cov khoom txawv teb chaws thiab lwm yam teeb meem. Cov lus nug ntawm seb puas muaj peev xwm coj x-ray rau tus menyuam yog txiav txim siab los ntawm tus kws kho mob tuaj koom. Hauv qhov no, qhov kev nyiam yuav tsum tau muab rau cov txheej txheem uas yog tus cwj pwm los ntawm kev siv hluav taws xob qis tshaj plaws.
Thaum ua CT, qhov txo qis ntawm qhov raug rau tus menyuam tau ua tiav los ntawm kev txo lub sijhawm ntawm qhov kis, nce qhov kev ncua deb mus rau emitter thiab tiv thaiv. Nws raug nquahu kom ua qhov kev ntsuam xyuas no siv "ceev" tomography (kev sib hloov ntawm lub raj ntawm lub cuab yeej ua tiav ntawm qhov ceev ntawm 0.3 s ib 1 kiv puag ncig).
Thaum xaiv lub tsev kho mob qhov twg yuav x-ray rau menyuam yaus, koj yuav tsum tau muab qhov nyiam rau cov neeg ua haujlwm uas tsim nyog thiab muaj kev paub dhau los, kom yav tom ntej koj tsis tas yuav rov ua cov txheej txheem no rau yav tom ntej. qhia meej qhov kev kuaj mob. Raws li kev tshawb fawb tsis ntev los no, kev pheej hmoo ntawm kev tsim cov kab mob malignant hauv cov menyuam yaus nce ntxiv yog tias tau txais X-ray koob tshuaj txog 50 mSv. Yog li ntawd, koj yuav tsum tsis txhob tsis kam mus rau radiography yog hais tias nws yog muab rau ib tug me nyuam vim kev kho mob.
Kev kuaj poj niam cev xeeb tub
X-ray ntawm cov poj niam cev xeeb tub yog coj los ntawm tib lub hauv paus ntsiab lus rau menyuam yaus. Raws li US College of Obstetricians, theem txaus ntshai ntawm hluav taws xob rau tus me nyuam hauv plab yog 50 mGy. X-rays feem ntau yog coj nyob rau hauv lub thib ob peb lub hlis twg ntawm cev xeeb tub. Yog tias tau txais kev raug mob hnyav lossis muaj qhov tsis txaus ntseeg, kev kuaj mob ntawm lub cev yog xav tau rau kev noj qab haus huv, ces yuav tsum tau pom zoo x-ray. Kev txwv tsis pub pub niam mis tom qab kuaj X-ray kuj tsis tsim nyog.
xam tomography tsuas yog ua rau cov lus qhia nruj, thaum lwm cov kev tshawb fawb tau ua tiav lawm. Nyob rau tib lub sijhawm, lawv sim txo qhov chaw raug thiab txo cov tshuaj tiv thaiv hluav taws xob siv cov ntxaij vab tshaus bismuth uas tsis cuam tshuam rau cov duab zoo.
Risk rau tus kws kho mob
Kev ua haujlwm hauv chav x-ray yog txuam nrog kev siv hluav taws xob ntau ntxiv. Txawm li cas los xij, cov kev tshawb fawb qhia tau tias yog tias txhua qhov kev xav tau kev nyab xeeb tau ua tiav, cov kws kho hluav taws xob tau txais ib xyoos ib zaug ntawm 0.5 mSv. Qhov no yog qhov zoo hauv qab qhov kev txwv tsis pub muaj txiaj ntsig. Tsuas yog nyob rau hauv cov kev tshawb fawb tshwj xeeb, thaum tus kws kho mob raug yuam ua hauj lwm nyob ze ntawm lub teeb hluav taws xob, tag nrho cov koob tshuaj tuaj yeem ncav cuag tus nqi txwv.
Ib xyoos ib zaug, cov neeg ua haujlwm ntawm chav X-ray yuav tsum tau mus kuaj mob nrog kev tshuaj xyuas kom ntxaws. Cov neeg uas muaj caj ces rau cov qog thiab cov qauv chromosome tsis ruaj tsis pub ua haujlwm li no.
