| ObjectiveTo investigate the safety and protective measures of 125 I radioactive seed implantation in the treatment of malignant tumor.Methods27 cases of patients with malignant tumors treated by 125 I radioactive seed implantation were analyzed from April 2012 to June 2015 in the department of gastrointestinal surgery, China Japan Union Hospital of Jilin University. Among this group, 2 cases of patients suffered from primary retroperitoneal tumors, 1 case of adrenal carcinoma patient with retroperitoneal recurrence, 5 cases of patients suffered from pancreatic cancer, 3 cases of cervical cancer with retroperitoneal metastasis, 5 cases of renal cancer patients with postoperative recurrence, 2 cases of ovarian cancer patients with retroperitoneal metastasis, 1 case of liver cancer with retroperitoneal metastasis, 2 cases of ureteral carcinoma patients with postoperative recurrence, 1 case of gastrointestinal stromal tumor with retroperitoneal metastasis, 1 case of brain glioma patient with retroperitoneal metastasis, 1 case of rectal carcinoid patient with postoperative recurrence, 1 case of bladder neoplasms patient with retroperitoneal metastasis, 1 case of malignant angioendothedioma patient with recurrence after excision, 1 case of patient with rectal melanoma. Male 9 cases, female 18 cases, age 39~75 years old and average age was 63.5, 1 cases of primary tumor, 26 cases of patients with peritoneal metastasis tumor; 1 cases of patient with 4 times seed implantation, 1 cases of patients with 3 times seed implantation, 16 cases of patients with 2 times of seed implantation, and total 48 times seed implantation. All the patients were diagnosed as malignant tumor by clinical manifestation, operation history, pathology or biopsy, tumor markers and radiological examination. All the patients had no indication of operation or the operation treatment, and the treatment of 125 I radioactive seed implantation was performed. The number of seed implantation, location, time, and protective measures were analyzed. The postoperative complications of 125 I radioactive seed implantation were analyzed, and especially the investigation and protection of patients after implantation of 3 years. To record and analyzed the operation and nursing care of the medical staffs, and to determined whether or not to take the protective measures, and to analyzed the problems in the clinical work.Result2 cases of patients with puncture site bleeding, and cured after hemostasis and other symptomatic treatment. 3 cases of patients with postoperative pain at the puncture site, but could be tolerated, and given no special treatment. 5 patients with varying degrees of particle displacement, but with no complications. This group of patients without radiation enteritis, intestinal fistula, infection and other complications; 27 patients were detected under protective status, and the radiation was lower than the standard of the International Commission on Radiological Protection(ICRP) and our country’s "radiation protection and safety of radiation sources" >>GBl8871 –2002, who’s dose limit of 50 m Sv / year for radiation workers was described, it demonstrated that the medical personnel were safe in the protection state; In this group, 27 patients with radioactive seed implantation were investigated with the knowledge of radiation protection, and the statistical analysis was carried out, it showed the proportion of patients who mastered the knowledge of radiation protection has increased, and it was important to the clinical radiation protection. The data analysis of the knowledge level of doctors and nurses before and after training was carried out, it also showed P=0.047<0.05, and demonstrated that the difference was statistically significant; Regular inspection of the body surface dose(every three months), and there is not yet a staff member exceeded the dose limit, it demonstrated that radiation protection measures were appropriate and effective. All patients were followed up at lest 4 months, even 3 years, and found no serious complications occurred due to radiation injury, all patients’ families did not find a case of radiation damage. To the present, there is no medical personnel who are engaged in radiation exceed the dose limit.InclusionThe treatment of 125 I radioactive seed implantation had few complications and was clinical safety. The radiation dose of 125 I radioactive seeds was small in the radiation protection state, which showed the importance of the patients’ protection. The training of patients and health care workers can improve the awareness of 125 I radioactive seeds, and enhance the degree of attention to radiation protection. In order to avoid radiation damage, radiation protection should be done before, intraoperative and postoperative 125 I radioactive seed implantation, and should be strictly managed,. |
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