Exposure to The words of Chen Shaohua, a member of the Chinese People's Political Consultative Conference, caused the term "naked inspection" to attract widespread attention in society. He said that most hospitals do not have any protective measures when performing X-ray examinations on patients. According to research by the International Commission on Radiation Protection, in a city with a population of 10 million, about 350 people may suffer from cancer or cancer every year due to exposure to X-rays. Leukemia or other genetic diseases. Moreover, the Ministry of Health has clearly stipulated that when doctors diagnose and treat patients, they should shield sensitive organs near X-ray exposure, but many hospitals do not implement this.
More than two months have passed, and reporters from "Life Times" once again visited a number of top tertiary hospitals in Beijing and found that the problem of "naked examination" has not yet been taken seriously and solved, and many patients are indifferent to it. On the contrary, many foreigners living in China told reporters that foreign countries have very strict protection requirements for CT, chest X-rays, etc. They do not even dare to do X-ray examinations in China because of fear of radiation.
First-class hospitals encountered "naked inspections"
On July 21, reporters investigated Beijing Tongren Hospital, Beijing Hospital and many other top hospitals in the country. There were long queues in front of their CT examination rooms and CT registration desks, and a large number of waiting people crowded the corridors. However, when the reporter asked multiple patients who came out of the examination room one by one, only one patient from Tongren Hospital said that the doctor wore protective clothing for him during the examination. In front of the X-ray examination room on the first floor of the inpatient department of Beijing Hospital, a young woman pushing an old man in a wheelchair had just received the examination report. She told reporters that not only did the doctor not ask the patient to wear protective clothing during the examination, but she, as an accompanying person, also did not wear one. But before entering the examination room, she clearly saw a poster on the wall outside saying that escorts should wear protective clothing.
During the investigation, the reporter found that the phenomenon of "naked examination" is relatively common, and medical staff rarely take the initiative to provide protective clothing. Ms. Zhang, who has had a physical examination at the Physical Examination Center of Peking Union Medical College Hospital, has a deep understanding of this. She said: "When I arrived at the chest X-ray room, the doctor directly asked me to stand in front of the instrument. I was worried that the radiation would be bad for my health, so I actively asked to wear protective clothing, and the doctor reluctantly took one out from under the shelf and gave it to me. "There are only a few patients like Ms. Zhang who are aware of protection. In most cases, doctors do not tell patients about the dangers of radiation, and patients themselves are unaware of it. At Tongren Hospital, a patient told reporters nonchalantly that X-rays were only taken once in a while and were over quickly, so there would be no problems.
Abuse leads to potential danger
In sharp contrast to the domestic "naked examination", foreign patients will be fully armed even if they take an X-ray of their teeth. This newspaper Journalists stationed in Germany have profound experience with this. Before filming, after the doctor introduced the X-ray radiation process to him in detail, he personally helped the reporter put on heavy lead protective clothing, covering his neck, chest, lower body and other parts, and also put on a protective hood. When everything is ready, the doctor will click the shutter.
Li Kuncheng, director of the Beijing Medical Image Quality Control and Improvement Center and director of the Radiology Department of Beijing Xuanwu Hospital, believes that insufficient protection is indeed common in China. The reason why foreign countries have done well in this regard is because There are few patients in the hospital. "For example, they only do around 20 patients with CT scans a day. A domestic hospital has to do at least one or two hundred CT scans every day. Although the country has relevant regulations and most hospitals are equipped with protective clothing, if every patient Wearing it is too troublesome and a waste of time, and you will definitely not be able to check it thoroughly.”
Research conducted by Oxford University and Cancer Research UK shows that the risk of X-rays is 0.6 in the UK, 1.5 in Germany, and 1.5 in Japan. There were 3.2 new cancer cases caused by X-ray and CT examinations. It is more harmful to pregnant women and children, can seriously damage children's intellectual development, and can also cause fetal malformations. However, Zhou Cheng, executive vice president of the Chinese Medical Imaging Technology Research Association, deputy chairman of the Radiology Branch of the Chinese Medical Association, and director of the Radiology Department of Beijing Hospital, pointed out that this is just an inference and there is no convincing clinical evidence.
But he acknowledged that potential risks from X-ray screening certainly exist, especially if they are misused. The Radiology Society of the Chinese Medical Association once released a set of data: About 250 million people in my country receive X-ray examinations every year, but 20 of them have no clinical significance. The abuse of CT is more common, and some hospitals even lower prices to attract patients.
Don’t take the initiative to ask for X-rays
According to the relevant regulations of the Ministry of Health, the radiation dose received by a continuously working radiology medical staff in a year should be less than 20 millisifurts ( msv), while taking an X-ray is 0.02-0.03 msv, and taking a CT is 6-8 msv. Feng Xiaoyuan, dean of Shanghai Medical College of Fudan University, chairman-elect of the Radiology Branch of the Chinese Medical Association, and director of the radiology department of Huashan Hospital, pointed out that the amount of radiation in routine examinations is within the safety range of the human body, but we should still do as little as possible . Adult physical examinations include CT and other X-ray examinations at most once a year. Repeat physical examinations are not necessary. If you are seeing a doctor, you should decide whether to have an X-ray examination based on your condition, and you should not actively ask for one. You can ask whether other methods such as MRI and B-ultrasound can achieve the same effect, and try to choose a method with a small amount of radiation that can ensure the inspection effect. He also reminded:
Proactively require radiation protection before the inspection. If a patient proactively asks if protective equipment is available, the hospital must provide it. Areas that are highly sensitive to X-rays, such as the gonads and thyroid gland, should be protected intensively.
Do not enter the examination room unless necessary. Do not go in the examination room when the red light is on, and try not to accompany the patient for X-ray examination. If it is really necessary, you must wear protective clothing.
Pregnant women and children need to be most vigilant. Unless there are special needs, pregnant women between 8 and 15 weeks pregnant should refuse abdominal X-ray examination. Many mothers eagerly request a CT scan after their child is injured, but fail to consider the radiation issue. A study in the American Journal of Radiology found that CT scans in children were not as effective as everyone thought, with only 7 detecting intracranial injuries.