| 摘要: | 隨著科技的進步，放射檢驗及治療儀器的不斷成長，目前一般人90%的輻射劑量來自醫療輻射。然而，放射影像的重照不但浪費醫療資源，也增加受檢者接受輻射劑量風險。本研究分析一般X光攝影重照類型，並且瞭解重照之影響因素，提出改善措施，降低X光影像的重照率，提升受檢者安全。
本研究收集2010年7月至12月之間某醫學中心數位影像系統資料庫之X光影像資料，分析重照率與受檢者特質、放射工作人員特質、攝影特性等之相關性。研究結果顯示整體影像之重照率為4.89%，擺位不正(56.2%)是重照的主要類型，兒童重照的主要類型為受檢者移動，而青壯年重照的主要類型為姿勢擺位不正；關於受檢部位，頭部檢查之重照率為最高(9.81%)，而重照影像中，以胸部檢查之重照比例最高 (32.09%)。重照影響因素分析的結果顯示，在受檢者特質方面，男性、老年人之重照率較高；工作人員特質方面，男性、年資低於兩年之工作人員有較高重照率；攝影特質方面，投射方向為側位(Later View)之重照率高於前後位投射(A-P View)。
瞭解分析一般X光攝影重照類型及影響因素之後，醫院可以建立更有效的教育訓練計劃，依據不同之重照類型與工作人員特質，加強工作人員之訓練，增加其專業知識與技能，有效降低重照率；並且可以針對重照率較高之受檢部位，加強工作人員之擺位技巧，減少重照率及輻射所造成之風險，提昇受檢者安全及改善醫療照護品質。
With the advance of technologies, X-ray equipment are growing and widely applied in the diagnoses and treatments of patient diseases in hospitals. In average, 90% of the daily radiation exposure for an individual comes from medical equipment. Image retaking of radiological examination not only wastes the medical resource but also increases the risk of radiation exposure of patients. This study aims at analyzing the factors affecting retake of general X-ray digital radiography so that better policies can be planned to reduce retaking rate and to improve patient safety. A total of 102,325 general X-ray images were retrieved from the image database from July to December, 2010 in a medical center situated in central Taiwan area. After excluding cases with incomplete data, 98,503 images were used for further analysis. The relations between image retaking rate and 3 constructs, including subject characteristics, technician characteristics, and type of examination, respectively, were investigated. The results show that (1) the total retaking rate is 4.89% which is similar to the previous investigations; (2) among the retaken images, posture (56.2%) is the main factor causing image retaking; (3) the retaking rate of head (9.81%) is ranked as the first place compared to the other body parts, although chest has the highest retaking proportion (32.09%) among all the retaking images; (4) after analyzing the subject characteristics, male and aged subjects have more retaking rates; on the other hand, the main cause for children retaking is body movement while posture is the main cause for young and middle-age adults; (5) male technicians and technicians with experience less than 2 years are responsible for higher retaking rate; and (6) lateral projection has higher retaking rate than anterior-posterior (AP) projection.
This study successfully verifies the following hypotheses: (1) subject characteristics is significantly related to retaking rate, (2) technician characteristics is highly related to retaking rate, (3) examined body part is strongly related to retaking rate, and (4) radiographic characteristics is closely related to retaking rate. The benefits of this study are as follows. (1) After having discovered the factors affecting retaking rate of digital X-ray radiograph, appropriate training programs can be planned to meet the need of individual technicians to elevate their professional skills, which is expected to be able to reduce the retaking rate. (2) By providing the information with regards to X-ray retaking rate and factors causing image retaking to managerial staff, policies for preventing retaking and enhancing equipment maintenance can be planned to reduce running cost and to increase cost-effectiveness of the hospital. |
