应用六西格玛管理法对放射科CT辐射剂量的管理  

Management of CT radiation dose in radiology department via applying Six Sigma management method

作　　者：邱海静 杜佳忆 李天来[2] 嵇志刚 潘奇[1] 王宁[1] 罗春海[1] QIU Haijing;DU Jiayi;LI Tianlai;JI Zhigang;PAN Qi;WANG Ning;LUO Chunhai(Department of Radiology,the Second Affiliated Hospital of Xi’an Medical University,Xi’an 710038,China;Shaanxi Provincial Center for Disease Control and Prevention,Xi’an 710000,China)

机构地区：[1]西安医学院第二附属医院影像科,陕西西安710038 [2]陕西省疾病预防控制中心,陕西西安710000

出　　处：《实用放射学杂志》2024年第7期1165-1169,共5页Journal of Practical Radiology

基　　金：陕西省卫生科技项目(2022B009)。

摘　　要：目的采用六西格玛管理法加强放射科CT辐射剂量管理。方法按照六西格玛质量管理DMAIC模式对放射科辐射质控流程进行优化,收集2022年1月至2022年2月成人和儿童常见CT检查项目容积CT剂量指数(CTDIvol)、剂量长度乘积(DLP)及辐射质控问题发生状况作为基线资料,2022年8月至2022年9月同一设备成人和儿童CTDIvol、DLP值及辐射质控问题发生状况作为实施六西格玛管理法后的对照资料,对实施前后剂量值和问题发生率进行比较、分析。结果成人DLP:CT尿路造影(CTU)降低65.5%、颈部增强降低25.5%、头颅降低9.8%、颌面部降低24%、胸部增强降低27.7%,差异均有统计学意义(P<0.05),腹部增强降低9.7%(P>0.05)。儿童头颅DLP:<1岁增加35%(P>0.05),1~5岁降低30.2%、6~10岁降低21.8%、11~15岁降低27.6%(P<0.05);儿童颌面部DLP:6~10岁降低43.3%、11~15岁降低29.1%(P<0.05);儿童胸部DLP:<1岁降低13%(P>0.05),1~5岁增加2.2%(P>0.05),6~10岁降低42.6%、11~15岁降低54.2%(P<0.05)。放射质控问题出现率明显降低。结论应用六西格玛管理法,发现放射工作中存在的问题,通过针对性优化,能够提升科室辐射质量控制管理水平。Objective To enhance CT radiation dose management in radiology department via applying Six Sigma management method.Methods The radiation quality control processes in the radiology department were optimized according to the Six Sigma quality management DMAIC pattern.The volume CT dose index(CTDIvol),dose length product(DLP),radiation quality control problems of adult and pediatric CT scans from January 2022 to February 2022 were collected as baseline data,and data collected from August 2022 to September 2022 were taken as the control group for analysis via Six Sigma management method.All data of the dose values and problem rates were compared and analyzed between before and after Six Sigma management methods.Results The DLP in the adult group was decreased by 65.5% in computed tomography urography(CTU),decreased by 25.5% in neck enhancement,decreased by 9.8% in head,decreased by 24% in facial cranial,and decreased by 27.7% in chest enhancement,with a statistical difference(P<0.05).While DLP in the adult group was decreased by 9.7% in abdominal enhancement,with no significant difference(P>0.05).The DLP in the pediatric(<1 year)group was increased by 35% in head scans,with no significant difference(P>0.05).While the DLP was decreased by 30.2% in 1 to 5 years group,decreased by 21.8%in 6 to 10 years group,decreased by 27.6% in 11 to 15 years group,with statistical difference(P<0.05).The DLP of facial cranial was decreased by 43.3% in 6 to 10 years group,decreased by 29.1% in 11 to 15 years group,with statistical difference(P<0.05).The DLP of chest was decreased by 13% in<1 year group(P>0.05),increased by 2.2% in 1 to 5 years group(P>0.05),decreased by 42.6% in 6 to 10 years group,decreased by 54.2% in 11 to 15 years group(P<0.05).The incidence of radiological quality control problems of after Six Sigma management was significantly lower than that of before Six Sigma management(P<0.05).Conclusion Six Sigma management method can identify problems in the clinical practice and enhance the ability of radiation quality con

关 键 词：六西格玛 计算机体层成像 辐射剂量 质量管理 

分 类 号：R814.42[医药卫生—影像医学与核医学] R142[医药卫生—放射医学]