摘要：目的 通过对职业受照人群的健康检查，了解必检项目的实施及漏检情况，分析原因、提供对策，提高健康监护及评价工作质量，更好控制放射工作人员确定性效应的发生，降低随机性效应的发生率，减轻放射工作人员职业性放射损伤。方法 选择2016年青海省不同受照工作人员1116名，包括从事医用普通X射线摄片、CT、介入治疗、核医学、放射治疗和其他非医疗单位辐射设备应用等，对其健康检查资料做统计分析。结果 总体上X射线胸片检查漏检率最高（56.6%），依次是眼科裂隙灯检查（37.0%）、实验室检查（11.2%）、电生理检查（5.8%）和内科检查（0.3%）；不同工种职业受照人群中：X射线胸片检查漏检率最高是CT室工种人员（84.9%），眼科裂隙灯检查漏检率最高是放疗人员（51.9%），实验室检查漏检率最高是核医学人员（14.8%），电生理检查漏检率最高是CT室人员（9.2%），内科检查漏检率最低。普放人群中县区级医疗单位漏检率最高（27.1%），个体诊所医院漏检率较低（11.6%）。结论 健康检查必检项目的漏检，不能全面反映放射人员健康状况，影响判断是否继续进行放射工作，不完整的体检报告直接影响放射场所效果评价工作，直接影响对放射工作人员确定性效应的发生和降低随机性效应的发生率控制。

Abstract: Objective To grasp the implementation of required examination items and missing examination items, enhance the quality of health supervision and assessment works, control the deterministic effect of radiation workers better, reduce the occurrence rate of stochastic effect and alleviate the vocational radiation injury of radiation workers by carrying out heath examination for population exposed to vocational radiation. Methods 1116 radiation workers in Qinghai in 2016 were chosen, including those who operate medical ordinary X-rays radiography, CT, interventional therapy, nuclear medicine, radiotherapy and other radiological equipment in non-medical units, for the statistical analysis of their health examination data. Results The highest examination missing rate was found in X-ray chest film examination (56.8%), which was followed by ophthalmological slit-lamp examination (37.0%), laboratory examination (11.2%), electrophysiological examination (5.8%) and internal medicine examination (0.3%). Among the population of different types of work exposed to vocational radiation, workers from CT department had the highest missing rate of X-rays chest film examination (84.9%), the radiotherapy personnel had the highest missing rate of ophthalmological slit-lamp examination (51.9%), the nuclear medical personnel had the highest missing rate of laboratory examination (14.8%), CT department workers had the highest missing rate of electrophysiological examination (9.2%). it is worth-noticing that internal medicine examination had the lowest examination missing rate. Among the general population, the county and district-level medical units had the highest examination-missing rate (27.1%) while individual clinics and hospitals had the lowest (11.6%). Conclusions The missing of required health examination items fails to comprehensively reflect the health conditions of radiation workers and judge whether these workers should continue with their works. The incomplete medical examination reports directly affect the assessment of radiation places and the control over the occurrence of deterministic effect of radiation workers and the reduction of occurrence rate of stochastic effect.