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中华医学超声杂志(电子版) ›› 2021, Vol. 18 ›› Issue (04) : 402 -406. doi: 10.3877/cma.j.issn.1672-6448.2021.04.011

所属专题: 乳腺超声 超声医学质量控制 文献

超声医学质量控制

质量改进模型在乳腺肿瘤患者术前超声诊断流程中的应用
马莉1, 秦菁1, 朱庆莉1,(), 刘赫1, 张璟1, 孝梦甦1, 王红燕1, 李建初1, 姜玉新1   
  1. 1. 100730 中国医学科学院 北京协和医院超声医学科
  • 收稿日期:2020-05-09 出版日期:2021-04-01
  • 通信作者: 朱庆莉
  • 基金资助:
    中国医学科学院医学与健康科技创新工程(2017-I2M-1-006); 北京市自然科学基金(7192177)

Application of model for improvement in preoperative diagnosis of breast lesions by ultrasound

Li Ma1, Jing Qin1, Qingli Zhu1,(), He Liu1, Jing Zhang1, Mengsu Xiao1, Hongyan Wang1, Jianchu Li1, Yuxin Jiang1   

  1. 1. Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2020-05-09 Published:2021-04-01
  • Corresponding author: Qingli Zhu
引用本文:

马莉, 秦菁, 朱庆莉, 刘赫, 张璟, 孝梦甦, 王红燕, 李建初, 姜玉新. 质量改进模型在乳腺肿瘤患者术前超声诊断流程中的应用[J/OL]. 中华医学超声杂志(电子版), 2021, 18(04): 402-406.

Li Ma, Jing Qin, Qingli Zhu, He Liu, Jing Zhang, Mengsu Xiao, Hongyan Wang, Jianchu Li, Yuxin Jiang. Application of model for improvement in preoperative diagnosis of breast lesions by ultrasound[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(04): 402-406.

目的

探讨质量改进模型(MFI)在乳腺超声术前诊断流程中的应用。

方法

连续性选取应用MFI前的2019年1月至2019年4月在北京协和医院乳腺外科接受乳腺手术的患者50例(对照组),以及应用MFI后的2019年7月至2019年10月在北京协和医院乳腺外科接受乳腺手术的患者50例(研究组)。研究组采用MFI改善乳腺超声就诊流程, 措施包括:乳腺超声专业组医师现场复核、加强乳腺亚专业组医师培训、改进预约分诊制度等;对照组未采用MFI。比较2组诊断符合率、未定性率及术前超声检查预约时间、来院检查次数的差异。

结果

研究组和对照组的诊断符合率分别为91.7%和70.5%,未定性率分别为4.0%和12.0%,2组比较差异均有统计学意义(P均<0.05)。研究组和对照组的术前超声检查预约时间分别为(0.58±0.98) d和(5.76±2.32) d,来院检查次数分别为(1.38±0.63)次和(2.52±0.67)次,2组比较差异均有统计学意义(P均<0.05)。

结论

应用MFI优化乳腺超声术前诊断工作流程,可有效利用现有医疗资源,使患者受益。

Objective

To explore the application of the Model for Improvement (MFI) in the procedure of preoperative diagnosis of breast ultrasound.

Methods

Consecutive patients with breast lesions who had a preoperative diagnosis by breast ultrasound were divided into either a study group (50 patients, from July to October 2019) or a control group (50 patients, from January to April 2019). In the study group, MFI was developed and used, which involved a series of actions such as on-site review by specialized doctors, training enhancement of specialized doctors, improvement of appointment procedures, etc. In the control group, no intervention was performed. The diagnostic accuracy rate, rate of undetermined diagnosis, appointment time, and number of hospital visits were compared between two groups.

Results

The diagnostic accuracy rates of the study and control groups were 91.7% and 70.5%, and the rates of undetermined diagnosis were 4.0% and 12.0%, respectively, with significantly statistical differences between the two groups (P<0.05). The appointment time of the study and control group was (0.58±0.99) days and (5.76±2.35) days, and the number of hospital visits was 1.38±0.63 and 2.52±0.67, respectively, with significantly statistical differences between the two groups (P<0.05).

Conclusion

MFI can optimize the procedure of preoperative diagnosis of breast ultrasound, make full use of the limited medical resources, and benefit more patients.

图1 实施质量改进模型前后乳腺肿瘤高危患者超声检查流程图
表1 应用MFI前后超声诊断符合率及未定性率比较[例(%)]
表2 应用MFI前后术前超声检查预约时长及来院检查次数比较(
xˉ
±s
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