目的

探讨PDCA（计划-执行-检查-处理）循环法对乳腺超声诊断质量控制的提升效果。

方法

以厦门市第三医院超声科为实施单位，该科室自2024 年1 月起将PDCA 循环法引入乳腺超声诊断质量控制体系，对乳腺超声诊断进行质量控制管理。回顾性分析实施PDCA 循环法前（2023 年1—12 月）、后（2024 年1—12 月）乳腺超声质量控制指标：乳腺病变超声报告进行乳腺影像报告和数据系统（BI-RADS）分类率、乳腺占位超声诊断准确率、乳腺超声报告书写合格率和乳腺超声图像切面合格率。采用Mann-Whitney U 非参数检验比较实施PDCA 循环法前、后上述指标的差异。

结果

实施PDCA 循环法后，乳腺报告BI-RADS 分类率、乳腺占位超声诊断准确率、乳腺超声图像切面合格率均较实施前提升（85.22% vs 67.01%，80.49% vs 71.79%，80.06% vs 60.12%），差异具有统计学意义（Z=-3.984，P＜0.001；Z=-2.288，P=0.020；Z=-4.025，P＜0.001）；乳腺超声报告书写合格率从97.92%略升至98.51%，但差异无统计学意义（P＞0.05）。

结论

PDCA 循环法显著优化了乳腺超声检查的核心质量，尤其在规范分类与图像标准化方面效果显著，该方法可有效推动乳腺超声诊断的标准化进程。

Objective

To evaluate the efficacy of the PDCA (Plan-Do-Check-Act) cycle method in improving the quality control indicators of breast ultrasound diagnosis.

Methods

This study was performed at the Ultrasound Department of Xiamen Third Hospital, where the PDCA cycle method was introduced into the breast ultrasound diagnosis quality control system starting in January 2024 to manage quality control.A retrospective analysis was performed on breast ultrasound quality control indicators before (January-December 2023) and after (January-December 2024) implementing the PDCA cycle method.The indicators included: the rate of Breast Imaging Reporting and Data System (BI-RADS) classification in breast lesion ultrasound reports, the diagnostic accuracy rate of breast masses by ultrasound, the qualification rate of breast ultrasound report writing, and the qualification rate of breast ultrasound image sections.The Mann-Whitney U non-parametric test was used to compare the differences in these indicators before and after PDCA implementation.

Results

After implementing the PDCA cycle method, the BIRADS classification rate (85.22% vs 67.01%), the diagnostic accuracy rate of breast masses (80.49% vs 71.79%), and the qualification rate of image sections (80.06% vs 60.12%) all showed significant improvements compared to those of the pre-implementation period (Z=-3.984, P＜0.001; Z=-2.288, P=0.020; and Z=-4.025, P＜0.001, respectively).The qualification rate of report writing increased slightly from 97.92% to 98.51%, but this difference was not statistically significant (P＞0.05).

Conclusion

The PDCA cycle method significantly optimizes core quality indicators for breast ultrasound examinations, demonstrating particularly notable effects in standardizing classification reporting and image acquisition.This method can effectively advance the standardization process in breast ultrasound diagnosis.