Roentgen has discovered X-rays for more than 100 years, but conventional imaging has been the focus of development in the field of radiology for a long time. Only radiologists and technicians are radiologists, and other personnel rarely come into contact with X-rays. After the 1990s, with the improvement of radiological equipment and the accumulation of medical experience, various treatments carried out under the guidance of X-rays, such as: heart, nerve, vascular interventional surgery and ERCP techniques such as local anesthesia, minimally invasive surgery, The advantages of high accuracy, less pain, and quick recovery are favored by doctors and patients. The feature of this type of operation is that the doctor needs to operate near the patient's table in the computer room, and is inevitably exposed to X-ray radiation. Yu Peng reported that the dose rate can reach 7.69 mGy/h when the staff position does not use various protective devices , and Zhao Zhongqing reported that the maximum dose rate on the surface of the arm of the cardiac intervention staff can reach 0.35 mGy/h. Take Nanjing Gulou Hospital as an example. As of the end of March 2009, there are more than 180 radiologists in the hospital, involving doctors and nurses in many clinical departments such as radiology, heart, nerve, digestion, vascular, orthopedics and general surgery. And other related operators. Long-term fluoroscopy and filming have made the radiation protection of people exposed to such rays a difficult point in current radiation protection. In addition, with the popularization of radiation knowledge, patients have higher and higher requirements for shielding protection, and hospitals are required to provide safe and effective body protection during X-ray examination and treatment. In addition to minimizing the time of exposure to X-rays and keeping a safe distance from X-ray radiation sources, the personal protection of medical staff and patients is mainly to wear lead protective clothing to achieve shielding protection. Therefore, the performance of lead protective clothing is important for medical staff. And patient safety is of great significance. 1 Types of lead protective clothing In radiological diagnosis and treatment, lead protective clothing can effectively resist the unnecessary damage of X-rays to important organs of the human body. Its protective effect is related to the energy of the rays, and the shielding efficiency is 90% to 95%. According to the different key protection parts, lead protective clothing includes one-piece lead clothing, lead tops, lead skirts, lead aprons, lead caps, lead collars, etc., which are used to protect the whole body, chest and abdomen, reproductive organs, lower limbs, and head. And thyroid and other important parts. The protective performance of lead protective clothing is expressed by lead equivalent (mmPb), that is, lead is used as a comparative standard, and the protective effect is expressed by the thickness of lead with the same shielding effect. Usually the front part of the one-piece lead garment is 1.0 mmPb and the back is 0.25 mmPb; the lead skirt is 0.35 mmPb; the lead collar and the lead cap are 0.35 mmPb. 2 Correct use and storage of lead protective clothing. Protective clothing should not be simply stacked when stored. Wrinkles and indentations should be avoided. When hanging the lead clothing, pay attention to the balance of the shoulders. The lead hanger should be careful not to have sharp edges to avoid scratching the lead clothing. If there are blood stains and other dirt on the surface of the lead clothes, they must be cleaned up in time. Neutral soapy water and clean water can be used, and chemical detergents should not be used as much as possible. Wipe them with a soft cloth and hang them to dry. 3 Elimination standard of lead protective clothing. Lead protective clothing meets the corresponding national standards in terms of lead equivalent, weight and material integrity when leaving the factory. However, due to frequent use or improper storage, common damages include the following aspects: fabric damage, containing The lead material is exposed; the seams are opened to form cracks; there are holes and cracks on the surface of the material; the material hardens and cannot be worn; due to long-term wear and suspension, the lead layer breaks from the shoulders and falls off to the hem; the lead clothes buckle is damaged, Unable to wear tightly; improper maintenance methods after the lead clothing is damaged cause the lead layer to leak; long-term use causes the upper part of the protective clothing to become thinner and the lead equivalent decreases. Typical normal images and various unqualified images are shown in Figure 3-8. In order to ensure the protective effect of lead protective clothing, the damage must be eliminated to a certain degree. 4 Lead protective clothing detection method (1) Number each lead protective clothing, and use the first letter combination of the English name of each department as the identification (such as: Radiology-RD, Intervention Room-DSA, Cardiology-CR, Digestion Section-ERCP, operating room-OR), the suffix number is numbered, this method number is clear, easy to identify and find, and then spray the number on the protective clothing by spray paint. Finally, a database of protective clothing is compiled, including types, departments, numbers, specifications, etc., as well as each test
time, test results, and processing methods. (2) Visually inspect the appearance to see if the lead-containing parts of the main body of the protective clothing are obviously damaged, such as cracks, cavities, creases, etc., whether the lead-free parts such as straps and clothes buckles are damaged. Visually unqualified protective clothing should Repair in time. (3) Perform a quick fluoroscopy inspection on the lead protective clothing on the PHILIPS TD digital gastrointestinal machine. In order to ensure the detection effect, the bed surface of the digital gastrointestinal machine is thoroughly cleaned before the detection to remove image background artifacts. Use manual parameter setting and low dose, do not use automatic brightness control, otherwise the device will automatically increase KV and tube current to avoid unnecessary radiation and tube load. Unfold the lead clothes and spread them flat on the bed without any wrinkles. Move the bed surface and lead garment to ensure that every detail is imaged under X-ray. The protected area on the image appears brown, while the damage, seams, and adhesives appear bright. (4) Use 100 kV for the damaged protective clothing to take pictures under automatic exposure conditions, save the images, measure and record the size and area of u200bu200bthe damaged part and register it in the database. (5) Through the use of perspective and filming, lead protective clothing can be found from small holes to large cracks, which is a simple and effective method to detect protective clothing.
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