臺灣博碩士論文加值系統

隨著醫學科技的發達，精準醫療環境漸漸成形的今日，影像醫學技術也隨著X光機技術提升造福許多病患。許多無法任意移動的急重症或隔離中的患者，需使用移動型X光機執行放射醫學檢查。由於加護病房缺乏輻射防護屏蔽，易造成醫師及護理人員恐慌。
本研究使用光激發光劑量計(Optical stimulated luminescence dosimeter, OSLD)在加護病房內進行環境空間劑量評估。將光激發光劑量計分別佈點在模擬受照病患之擬人型假體病人背後，離地面70公分高度的加護病房內外兩側牆壁、兩相鄰病房間的護理工作站、鉛屏蔽前面及鉛屏蔽後面30、60、90公分各放置三個OSLD。移動型X光機照射條件採用一般成人胸部X光條件，固定管電壓(85 kVp)、管電流及曝射時間(6.3 mAs)，主射束方向連續曝射三次後再將檢查床轉90度垂直鉛屏蔽方向，相同的曝射條件下再連續曝射三次後的累積劑量，評估射源方向改變造成病房外產生較高的輻射累積劑量分布之影響。
研究結果顯示檢查床方向垂直鉛屏蔽會造成兩相鄰病房間護理工作站周圍產生較高散射輻射劑量為2.67微西弗。鉛屏蔽後面輻射劑量與背景輻射相近。本研究成果可提供加護病房醫療人員了解移動型X光機執行放射醫學檢查空間劑量分布，以建立輻射屏蔽安全距離達到輻射安全的工作環境。

The precision medical environment has gradually taken shape. Imaging medicine technology has aslo benefited many patients with the improvement of X-ray machine technology. Many critically ill or isolated patients who cannot be moved at will need to use mobile X-ray machines to perform radiology examinations. Because the design of the general ward and intensive care unit lack radiation protection shield. So it cause panic among doctors and nursing staff.
This study of OSLD was used to evaluate the dose of patients and environment in ICU. Three oslds were placed on the back of the anthropomorphic prosthesis, on both sides of the intensive care unit at 70 cm above the ground, the octagonal window sill of the nursing workstation, and 30 / 60 / 90 cm behind the lead shield. The fixed tube voltage (85 kVp), tube current and exposure time (6.3 mAs) were used for the mobile X-ray machine. After three times of continuous exposure in the main beam direction, the table was rotated 90 degrees perpendicular to the lead shielding direction, and then exposed for three times under the same conditions (85 kVp × 6.3 mAs). The results show that the vertical lead shielding in the direction of examination table will cause high scattered radiation dose around the octagonal window sill of nursing workstation. The radiation dose of lead shielding is similar to that of background radiation. The results of study could provide medical staff in ICU to understand the spatial dose distribution of radiation medical examination performed by mobile X-ray machine, so as to establish radiation shielding safety distance and achieve radiation safety working environment.
Provide medical radiologists and other medical staff with a clear understanding of the as low as reasonably achievable (ALARA) dose distribution. Find a feasible radiation safety shielding distance to achieve a radiation safety protection working environment.

碩士論文口試委員審定書 I
誌 謝 II
中文摘要 III
Abstract V
目 錄 VII
圖 目 錄 IX
表 目 錄 XI
第一章 緒 論 1
1-1 研究動機 1
1-2 研究目的 1
第二章 研究背景 2
2-1 名詞解說 2
曝露:分為體外曝露與體內曝露 2
曝露量(Exposure, X) 2
相對生物效應(Relative biological effectiveness, RBE) 2
組織加權因數(Tissue weighting factor, WT) 2
吸收劑量(Absorbed dose, D) 3
器官劑量(Organ dose) 3
等價劑量(Equivalent dose, H) 4
有效劑量(Effective dose, E) 4
輻射健康效應 4
合理抑低 5
光激發光劑量計(Optically Stimulated Luminescence Dosimeter, OSLD) 6
輻射防護TSD原則:時間Time、屏蔽Shield、距離Distance 10
2-2文獻回顧 11
第三章材料與方法 13
3-1材料 13
擬人型假體(Anthropomorphic Phantom) 13
移動式X光機 14
輻射防護之活動式視窗鉛屏蔽(MED/LAND) 15
擬人型衣架假體與活動抽屜櫃 16
光激發光劑量計OSLD 17
內科加護病房 20
3-2方法 22
研究流程圖 22
OSLD 佈點圖 23
研究方法 25
第四章 結果與討論 29
4-1 光激發光劑量計特性篩選結果 29
4-2 光激發光劑量計校正曲線結果 30
4-3 光激發光劑量計型號修正係數 30
4-4 檢查床垂直MI-02床頭牆輻射度量結果與討論 31
4-5 檢查床垂直病房門口之鉛屏風輻射度量結果與討論 32
4-6 醫事放射師職業曝露與醫療人員劑量評估 34
第五章 結論 36
參考文獻 38

1. Antonov-RomanovskiiV.V.,Kcium-MarcusI.F.et.al. IR stimulable phosphors ,Conference of the Academy of Sciences of the USSR on the Peaceful Uses of Atomic Energy, Moscow, USAEC, 239-250, 1956.
2. Brǎunlich P., Schǎfer D.et al, A simple model for thermoslumine scence and thermally stimulated conductivity of inorganic photoconducting phosphors and experiments pertaining to infra-red stimulated luminescence ,Proceedings of the First International Conference on Luminescence Dosimetry, Stanford, USAEC, 57-73, 1965.
3. Sanborn E.N. and Beard E. L.et al ,In infra-red stimulated luminescence dosimetry ,Proceedings of the First International Conference on Luminescence Dosimetry, Stanford, USAEC,183-191, 1967.
4. Huntley D.J., Godfrey-Smith D. I. The walt M.L.W., Optically dating of sediments ,Nature, 313, 105-107, 1985.
5. Hu B., and Wang Y., Performance of Al2O3 :C optically stimulated luminescence dosimeters for clinical radiation therapy applications ,Australasian Physical and Engineering Sciences in Medicine, 2009，32:4.
6. Yuki hara E.G. and McKeever S.W.S, Optically stimulated luminescence dosimetry in medicine , Physics in Medicine and Biology,2008，53, R351-R379.
7. Botter –Jensen L., McKeever S.W.S., et. Optically stimulated luminescence dosimetry, Elsevier Science B. 2003.
8. LeeS.Y.,Lee K.J., Development of a personal dosimetry system based on optically stimulated luminescence of α-Al 2O3 : C for mixed radiation fields, Applied Radiation and Isotopes,54, 675-685, 2001.
9. Akse lrod M.S., Botter Jensen L., Mckeever S.W.S. , Optically stimulated luminescence and its use in medical dosimetry, Radiation Measurements, 41, S78-S99, 2007.
10. 湯明宗，白宗庭，林招膨，陳宜清，等人；光激發光劑量計應用於移動式X光機輻射劑量之評估，臺灣應用輻射與同位素雜誌 .Dec 2017; Vol. 13, No. 4, P 1533-1540
11. 高紫綾 ，葉善宏等；光激發光劑量計與氟化鋰熱發光劑量計輻射偵測特性之研究比較，Taiwanese Journal of Applied Radiation and Isotopes .Dec 2012；Vol.8，No.4，P 411-418
12. 李超群，鍾國晃，陳拓榮，李文禮等人；移動式X光機周遭之空間劑量評估，中華放射線技術學雜誌，2005；Vol. 29，No.1，P19-27
13. 胡中昇，李桂樑，楊枝哲，黃姿婷，林招膨等人；利用游離腔偵測器評估移動式X光機周圍劑量，臺灣應用輻射與同位素雜誌，Dec 2010；Vol.6，No.4，P 954-959
14. 蔣獻文，陳拓榮，林松水，趙世裕等人；移動式X光機之空間劑量評估，中華放射線技術學雜誌，2012；Vol.36，No.4，P216-222
15. 行政院原子能委員會，游離輻射防護法第17條。