A few days before physical examination, semen overflowed, is it influential?

Haha, I've wanted to write this question for several years, but I haven't had the heart to write it, because the more citizens I know, the more the work of doctors will be supervised, but the issue of radiation protection is related to the health of the whole country. Nowadays, the diseases caused by radiation are increasing day by day, among which the diseases caused by home improvement industry have attracted full attention, but the medical irradiation part has not been paid enough attention. Not only do citizens know little about the dangers of radiation, but even medical staff don't know enough, so haha, I don't want to extract some relevant regulations.

First, introduce the "ten-day principle". Women of childbearing age must master the "ten-day principle" when applying for radiation examination, so they should be examined ten days before menstruation to avoid radiation exposure to embryos. Women with overdue menstruation should be considered pregnant unless there is evidence that they are not pregnant. Radiology staff should ask women with unclear pregnancy, and take the initiative to negotiate with clinicians to decide whether to carry out radiation examination according to the patient's situation. Radiology department has the right to return the application form if it is not necessary.

Haha comments: Very few hospitals can really implement the "ten-day principle", and not many doctors know what the "ten-day principle" is. As a result, cases of unnecessary exposure of pregnant women often occur, and some pregnant women even have to induce labor or give birth.

The ten-day principle is a strict rule, which is difficult to implement. It is suggested that pregnant women should be prohibited. If you are not sure whether you are pregnant, please don't do a radiation test, otherwise you will be at your own risk. " Some hospitals have visited the court because of pelvic fluoroscopy for pregnant women, and other hospitals must be cautious.

About penetrating ring

Haha, the problem of piercing has been raised many times at this point. Today, the relevant regulations are emphasized again: gynecological examination and B-ultrasound examination should be carried out first, and X-ray examination can only be carried out if the above examination cannot be diagnosed. X-ray examination without clinical indications should be avoided, and the number of X-ray ring penetration in women should be strictly limited, no more than twice in the first year after wearing the ring, and no more than 1 times every 1-2 years thereafter. Women of childbearing age are forbidden to wait in line in the computer room when wearing rings.

Haha comments: Due to the requirements of national policies such as family planning and the lack of medical knowledge of some people, the abuse of X halo is very common. Some cities even require women of childbearing age to have X-ray halo examination four times a year. This is a very surprising thing. As we all know, women are different from men, and men's sperm is used with life, and it is full of sperm. Even if the sperm is distorted, after ejaculation can produce normal sperm in the future. However, women's reproductive function has laid the foundation in the fetal period. There are hundreds of thousands of eggs in the neonatal period, and more than 99% of them die one after another (follicular atresia). Only at the reproductive age, the follicles mature and the mature eggs are discharged. Only a few of these hundreds of eggs are pregnant (varies from person to person), and only one fertilized egg (made by an only child) is born on average. It can be seen that too much pelvic irradiation by women will cause irreparable losses to individuals. If you give birth to a deformed baby, it is also a heavy price for society and families. So haha, again, B-ultrasound is the first choice for ring inspection, and X-ray inspection is really needed. Local photos of pelvic cavity are the first choice, and the ring piercing four times a year must be cancelled as soon as possible!

About mammography

It is stipulated that women of childbearing age who have no clinical symptoms should avoid X-ray mammography. Women under the age of 50 should not have regular mammograms (except for special circumstances such as family history of breast cancer). Women under the age of 20 should use mammography with caution (not necessary in principle, haha), and women of childbearing age must protect their eyes and thyroid gland when doing mammography.

Haha comments: In recent years, due to economic drive and other reasons, the publicity of mammography is increasing, and it is not uncommon to encourage mammography for physical examination and take mammography as some routine examinations. In fact, there have been countless data to prove that the overall value of mammography is negative for people under 50 years old (the overall harm is far greater than its benefits, only the benefits for patients, and of course, the benefits outweigh the disadvantages for medical institutions with business commissions). It is said that there is a tendency to abolish mammography abroad (instead, it is a higher-tech examination, so some developed countries are eager to transfer mammography machines to developing countries such as China). In fact, there are not many common breast diseases, mainly hyperplasia, fibroma and breast cancer. Experienced breast doctors have a high accuracy of palpation, and many photos that are difficult to judge by palpation can only be diagnosed by biopsy.

Other provisions:

In principle, pelvic measurement should not be performed for pregnant women, and it should be performed at the end of pregnancy if necessary. Pregnant women should not have routine chest X-ray examination before delivery. To strictly grasp the indications of hysterosalpingography, it is really necessary to do it 5- 10 days after menstruation is clean (some experts think it is 3-7 days), and avoid pregnancy within 3 months after examination. In principle, pregnant women do not have any X-ray examination (especially 8- 15 weeks of pregnancy), unless there are special reasons such as saving lives or preparing to terminate pregnancy.

Haha comments: Most hospitals have implemented the above points very well. Pelvic photos were taken many years ago, and now they have been basically cancelled.

You protect women of childbearing age, you protect half the children. Let's talk about child protection.

Without special permission, children shall not be treated as teaching and scientific research cases for X-ray examination. In addition to the necessary clinical fluoroscopy, children should also undergo X-ray photography. When irradiating children, use equipment that fixes the position of children. Children should not be raised by staff or accompanying personnel unless there are special circumstances. When support is needed, protective measures should be taken for the supporters. Children's X-ray examination must pay attention to the protection of non-examination parts (especially the protection of gonads and crystals). There are many rules (omitted).

Haha comments: There are many children with hematological diseases. There is no doubt that radiation is an important inducement. Children are sensitive to radiation, so it is difficult to cooperate with the inspection, so it is necessary to strengthen the protection management.

"In addition to the clinical necessary fluoroscopy, children should also undergo X-ray photography examination." The viewpoint that medical examination fluoroscopy should be abolished has been put forward many times. Nowadays, in some cities, children who enter the park have to undergo routine chest examinations (not to mention primary schools, middle schools, universities, etc.). In fact, this is a serious violation of application legitimacy and radiation protection optimization. This behavior must be stopped as soon as possible. It is an inaction for the management to let this practice go unchecked. Actually, there are many ways to make money. It is really unforgivable to ignore the health of a generation for a few dollars of medical examination fees. In fact, you should not have a chest X-ray when you enter kindergarten (except for some people with special reasons, there is no need to have a chest X-ray).

"Without special permission, children may not be used as teaching and scientific research cases for X-ray examination." This situation also exists. Some people don't hesitate to take pictures of some people regularly in order to write articles on certain aspects. It is said that some even take children to do nuclear medicine experiments for scientific research (the experimented people don't know). Scientific research is a good thing and an important work to promote the development of medicine. But remember the old saying, "Don't do to others what you don't want others to do to you", and informed consent must be followed, although it is not easy to do under the current national conditions in China.

"When irradiating children, you should use equipment that fixes the position of children. Children should not be raised by staff or accompanying staff unless there are special circumstances. When you have to support them, you should take protective measures for the supporters. X-ray examination for children must pay attention to the protection of non-examination parts (especially the protection of gonads and crystals). " Not many hospitals can really implement these two points. Although this kind of fault is minor, once the court wants to see the hospital, it is inevitable to lose the case.

I talked about the protection of women and children, and finally talked about the protection principles for ordinary patients. Before talking about this issue, let's introduce the internationally recognized basic principles of radiation protection management.

1, the principle of legality (rationality). After comprehensive balance, it is reasonable to think that the income obtained from this inspection obviously exceeds the total cost (including the cost caused by biological hazards). In short, it is icrp's "all activities should not be accepted unless they can produce positive net benefits".

2. Optimization principle. Ensure that the examination is carried out at a sufficiently low dose level when the specific economic and social environment allows. In other words, this choice is the most suitable choice.

3, personal measurement limit, mainly in order to reduce the occurrence of radiation hazards and set the dose limit. It's too professional to explain in detail.

In order to realize these three principles, the state has promulgated more than 100 related laws and standards, and spent hundreds of millions of yuan on radiation protection training for doctors every year, and the result is about zero (only the protection effect for patients is about zero, and the protection for employees is greatly improved)! Most of the regulations are unknown and have not been implemented (only referring to the protection of subjects). Radiation protection in China still has a long way to go.

Principles of protection for general patients.

1, "In addition to clinical fluoroscopy, try to take photographic examination to reduce the exposure dose of patients and staff." Haha, this question has been said many times. Unfortunately, many people (including doctors) don't understand. They always think that photos have more light and less perspective light. In fact, according to a chest X-ray, the exposure time is generally 0.0 1 second, but if you look at the chest X-ray carefully, it will take tens of seconds, at the earliest, it will take more than 10, so it is 10, and the exposure time difference is 65438+.

2. "Strictly adjust the irradiation field during photography (generally, the irradiation area shall not exceed 10% of the film) to protect the non-projection part of the subject. No one is allowed to stay in the computer room except those who are being inspected. When the inspected must support, the supporters should be protected. " In fact, the state requires that the computer room must be equipped with protective clothing, such as chest X-ray, and the lower abdomen (mainly to protect gonads), neck (mainly to protect thyroid gland) and head (mainly to protect crystals) should be covered with lead clothing. And many hospital computer rooms don't have lead suits at all, and even if they do, they just take them out for a big inspection. Foreigners have complained to the hospital because the hospital did not provide lead clothing to protect the non-examined parts. The above provisions should also be gradually implemented in the future.

3. "Clinicians should not blindly apply for radiological examination, radiologists have the right to refuse applications that do not conform to the principle of legality, and radiologists should adhere to the film evaluation system, improve the level of projection, reduce the rate of waste films, and avoid the occurrence of duplicate photos." Due to profit commission and evidence inversion, the application rate of radiological examination has been greatly improved. In fact, some of them do not conform to the principle of legality. Radiologists (not technicians or registrars) have the right to refuse applications that are really harmful and unprofitable (but because of the good relationship between departments, radiologists should politely negotiate with the applicants and explain the reasons why they should not do it). Good photo quality is the basis of correct diagnosis, and poor photo quality should be re-photographed. Projection technicians must carefully project photos to avoid duplication of waste films and photos due to photo quality problems, and no extra charges are allowed (those who need extra photos due to illness are charged according to regulations). The technicians who caused the scrap should be punished.

There are many other regulations (omitted).