KOMPARASI DOSIS RADIASI YANG DITERIMA OPERATOR PERCUTANEOUS CORONARY INTERVENTION DENGAN NILAI BATAS DOSIS MENURUT PENETAPAN BADAN PENGAWAS TENAGA NUKLIR

SHISKA NOVALIA, dr. Sri Retna Dwidanarti, Sp.Rad(K)Onk.

2015 | Tesis | SP RADIOLOGI

Pendahuluan. Prosedur intervensional terapetik yang paling banyak dilakukan di RSUP Dr. Sardjito adalah percutaneous coronary intervention (PCI). Pemantauan dosis radiasi yang diterima oleh operator dan menjaga dosis tersebut berada dalam batas aman yang ditentukan sangat penting untuk dilakukan agar efek radiasi yang mungkin terjadi dapat dihindarkan. Tujuan penelitian. Membandingkan dosis radiasi tiap tindakan dan dosis kumulatif dalam lima minggu yang diterima operator PCI dengan nilai batas dosis (NBD) dan membandingkan dosis radiasi rerata di setinggi dada dengan di setinggi gonad. Subjek dan metode. Penelitian ini merupakan penelitian deskriptif analitik observasional komparatif. Subjek penelitian adalah operator yang melakukan tindakan PCI di Cath-lab Room 1 dan 2 Instalasi Radiologi RSUP Dr. Sardjito pada Februari-April 2014, yang memenuhi kriteria inklusi dan eksklusi. Pengambilan sampel penelitian dilakukan dengan cara consecutive sampling. Pengukuran dosis radiasi dilakukan dengan dua dosimeter saku yang diletakkan di dalam apron di setinggi dada dan di setinggi gonad. Analisis hubungan antar variabel dilakukan secara analitik komparatif, dengan hipotesis komparatif-numerik. Hasil. Pada penelitian ini didapatkan 35 tindakan PCI yang dikerjakan oleh dua operator, laki-laki, dengan fluoro time 15,337 ± 13,336 (SD) menit, dosis radiasi di setinggi dada 12,6 ± 22,92 (SD) Sv, dan di setinggi gonad 37,1 ± 52,72 (SD) Sv. Pada komparasi per tindakan: dosis di setinggi dada sejumlah 18 tindakan  NBD dan di setinggi gonad sejumlah 17 tindakan  NBD (p = 0,000). Pada komparasi dosis kumulatif lima minggu: dosis yang diterima kedua subjek di dua tempat pengukuran tersebut tidak melebihi NBD. Pada komparasi dua tempat pengukuran: dosis di setinggi gonad > di setinggi dada 15 tindakan, dosis di setinggi gonad = di setinggi dada 16 tindakan, dan dosis di setinggi gonad < di setinggi dada 4 tindakan (p = 0,000). Simpulan. Pada penilaian dosis radiasi whole body pada tindakan PCI didapatkan: dosis per tindakan di setinggi dada lebih rendah dari NBD sedangkan dosis di setinggi gonad lebih tinggi dari NBD; dosis radiasi kumulatif dalam lima minggu lebih rendah dari NBD. Pada komparasi dua tempat pengukuran didapatkan dosis di setinggi gonad lebih tinggi daripada di setinggi dada. Kata kunci: keamanan radiasi, pekerja radiasi, percutaneous coronary intervention, fluoroskopi, dosimeter saku

Introduction. Percutaneous coronary intervention (PCI) is the mostly done therapeutic interventional procedure in RSUP Dr. Sardjito. Monitoring the radiation dose received by operators and ensuring that dose within the safe limit are very important to avoid the possible radiation effects. Aims. The aims of this study were to compare the radiation dose of each PCI and cumulative dose received by operator to the radiation exposure limit (nilai batas dosis/NBD) and to compare the radiation dose at gonad height to chest height. Subject and Method. This was a comparative analytic observational study. Subjects were the operators of PCI procedures in Cath-lab Room 1 and 2 RSUP Dr. Sardjito in February-April 2014 who met the inclusion and exclusion criteria. The sampling method was consecutive sampling. The association between variables was analyzed comparatively, using numeric-comparative hypothesis. Results. There are 35 PCI performed by two operators, who are all male, with fluoro time 15,337 ± 13,336 (SD) minutes, radiation dose at chest height was 12,6 ± 22,92 (SD) Sv, and at the gonads height was 37,1 ± 52,72 (SD) Sv. In per PCI comparative analysis, it was found that: radiation dose at chest height 18 PCI was  NBD and radiation dose at gonads height 17 PCI was  NBD (p = 0.000). In five weeks cumulative dose analysis, it was found that: radiation dose of each subjects was not exceeding NBD. In comparative analysis of radiation dose at gonads height to at chest height, it was found that 15 samples show the radiation dose at the gonads height > at chest height, 16 samples show the radiation dose at the gonads height = at chest height, and 4 samples showed the radiation dose at the gonads height < at chest height (p = 0.000). Conclusion. In the whole-body radiation dose assessment of PCI: per PCI dose at chest height was lower than NBD, while at gonads height was higher than NBD; cumulative radiation dose in five weeks of each operator at chest height and at gonads height was less than NBD; radiation dose at gonads height was more than radiation dose at chest height. Key words: radiation safety, occupational radiation, percutaneous coronary intervention, fluoroscopy, pocket dosimeter

Kata Kunci : keamanan radiasi, pekerja radiasi, percutaneous coronary intervention, fluoroskopi, dosimeter saku; radiation safety, occupational radiation, percutaneous coronary intervention, fluoroscopy, pocket dosimeter