目的 了解分化型甲状腺癌术后行 ¹³¹I治疗的患者体外辐射剂量变化,探讨患者出院日及临床过程中的辐射防护方法。 方法 选取分化型甲状腺癌术后进行 ¹³¹I治疗的患者74例,在治疗后24 h、48 h、72 h、96 h,使用放射性核素治疗监护机器人测量距患者颈部及1 m处的体外辐射剂量水平,并与出院参考标准进行比较。 结果 行 ¹³¹I治疗后24 h、48 h、72 h、96 h,距患者1 m处辐射剂量为270.11（202.46,427.18）、64.02（39.01,101.19）、16.74（10.07,27.69）、5.28（3.41,10.40）;行 ¹³¹I治疗后24 h、48 h、72 h、96 h,辐射剂量符合出院要求的患者分别为0例、2例（2.7%）、52例（70.3%）、70例（94.6%）。 结论 甲状腺癌患者行 ¹³¹I治疗后体外辐射剂量变化差异性较大,建议动态检测患者行 ¹³¹I治疗后1 m处的体外辐射剂量,按照辐射剂量要求执行个体化出院时间。医护人员接触患者时要做好防护,可使用放射性核素治疗监护机器人完成部分工作。

Objective To understand the radiation dose changes of patients receiving iodine after operation for differentiated thyroid cancer,and to discuss the best protection when patients were discharged and during the process of staying in hospital.Methods A total of 74 patients with differentiated thyroid cancer who received ¹³¹I treatment after surgery were selected. At 24 h,48 h,72 h and 96 h after treatment,the radiation dose levels on the neck and 1m far away from the patients were measured by the radionuclide therapy monitoring robot,and compared with the reference standards of discharge. Results At 24 h,48 h,72 h and 96 h after ¹³¹I treatment,the radiation dose 1m away from the patient was 270.11（202.46,427.18）,64.02（39.01,101.19）,16.74（10.07,27.69）,5.28（3.41,10.40）respectively. At 24 h,48 h,72 h and 96 h after ¹³¹I treatment,0 patient,2 patients（2.7%）,52 patients（70.3%）and 70 patients（94.6%）met the discharge dose requirements. Conclusion Radiation dose changes of thyroid cancer patients after ¹³¹I treatment is great among different patients. It is suggested to dynamically detect the radiation dose at 1 m after ¹³¹I treatment and individualized discharge schedule is advocated. Medical staff should be well protected when contacting patients,and the radionuclide therapy monitoring robot can be used to complete part of the work.