降低嬰幼兒胸腹部X光攝影之重照率

Reduction of Image Retake Rates of Chest and Abdominal X-ray Digital Radiographs in Infants and Young Children

在臨床攝影中，嬰幼兒常因哭鬧、不願配合照相等因素，導致影像重照，而嬰幼兒接受輻射致癌機率較成人為高，故本研究希望瞭解嬰幼兒X光攝影重照之因素，提出改進方案，減低重照率，以減少重照所造成額外的輻射劑量。本研究係自行開發製作嬰幼兒X光照像輔助器材，幫助約束嬰幼兒肢體，利用貼紙、小玩具、花俏的鉛衣及撥放卡通音樂等方式來安撫小朋友情緒，營造嬰幼兒攝影檢查的環境及衛教家屬正確的固定嬰幼兒肢體，達到有效且安全之嬰幼兒X光影像檢查。影像模糊衍生之重照率由2.79%降低至0 .75%，降幅72.98%（p<0.001），不能配合擺位引起部位偏移所衍生之重照率由2.06%減降低至0.34%，降幅83.70%（p<0.001）， 因異物產生假影重照率由0.88%低至0.42%，降幅52.47%（p<0.05）。整體重照率由6.47%降至l.75%（p<0.001）。經過運用嬰幼兒輔助工具等改善計畫，除能減少嬰幼兒重照率外，亦能縮短檢查時間（4.5分鐘減少至2.8分鐘），並提高家屬之滿意度（71.8%至84.6%）及工作人員使用輔具後之整體滿意度（87.5%）。另開發出之輔具可有效應用於3歲以下之嬰幼兒並降低輻射所造成之風險。

This study aims to assess the factors affecting the need to retake in chest and abdomen X-ray of children under 3 years old in order to devise a plan for reducing the retake rate and avoid unnecessary X-ray exposure on children.We developed assistive devices that might help reduce body movement in young children during X-ray radiography.The use of stickers, small toys, fancy lead clothes and cartoon music helped soothe the children’s emotions. Furthermore, we created an environment that the children liked and educated their family about how to restrain their children‘s body in order to ensure an effective and safe take of an X-ray radiograph. Retake rates due to blurred images, out of position images and artifact images decreased from 2.79% to 0.75%(drop 72.98 %, p<0.001), 2.06% to 0.34%(drop 83.70%, p<0.001)and 0.88% to 0.42%(drop 52.47%, p>0.05), respectively. Overall retake rate was decreased from 6.47% to 1.75%(p<0.001). Using assistive devices to help restrain of infants’ and children’s body can effectively reduce the retake rate of chest and abdomen X-ray radiographs. In addition, these devices can also shorten examination time (reduced from 4.5 minutes to 2.8 minutes), and improve family satisfaction (71.8% to 84.6%) as well as overall satisfaction (87.5%). These assistive devices can be effectively used with children under three years old and reduce risk of stochastic effects by radiation.