医学尸检作为临床医学中的质量保证工具：梦想与现实。
The medical autopsy as quality assurance tool in clinical medicine: dreams and realities.
作者信息
van den Tweel Jan G, Wittekind Christian
机构信息
Department of Pathology, University Medical Center Utrecht, H4-312, 3584 CX, Utrecht, The Netherlands.
Institut für Pathologie, Universitätsklinikum, Leipzig, Germany.
出版信息
Virchows Arch. 2016 Jan;468(1):75-81. doi: 10.1007/s00428-015-1833-5. Epub 2015 Aug 28.
Abstract
The purpose of medical autopsy has changed to issues of quality assurance today. In addition, autopsies are considered valuable in medical education, e.g., delivering cases for problem-based learning for students. Many studies underscore the need for autopsies also in the era of technical progress emphasizing the continuing discrepancies between antemortem and post mortem diagnoses. Despite these important tasks, we face a decline of autopsy for several reasons with complex interactions. The role of all persons involved in this decline is evaluated and suggestions for changes are proposed. Last but not least, the future of the autopsy is in the hands of pathology itself.
摘要
如今，医学尸检的目的已转变为质量保证问题。此外，尸检在医学教育中被认为具有重要价值，例如为学生提供基于问题的学习案例。许多研究强调，在技术进步的时代，尸检仍有必要，因为生前诊断与死后诊断之间仍存在持续的差异。尽管有这些重要任务，但由于多种复杂的相互作用因素，我们仍面临尸检数量下降的问题。本文评估了所有导致这种下降的相关人员的作用，并提出了改进建议。最后但同样重要的是，尸检的未来掌握在病理学自身手中。
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本文引用的文献
1
The clinico-pathological conference, based upon Giovanni Battista Morgagni's legacy, remains of fundamental importance even in the era of the vanishing autopsy.基于乔瓦尼·巴蒂斯塔·莫尔加尼的遗产而举办的临床病理讨论会，即便在尸体解剖逐渐减少的时代，依然具有至关重要的意义。
Virchows Arch. 2015 Sep;467(3):249-54. doi: 10.1007/s00428-015-1785-9. Epub 2015 May 20.
2
Post-mortem tissue biopsies obtained at minimally invasive autopsy: an RNA-quality analysis.微创尸检获取的尸检组织活检：RNA质量分析
PLoS One. 2014 Dec 22;9(12):e115675. doi: 10.1371/journal.pone.0115675. eCollection 2014.
3
Discrepancies between clinical and autoptic diagnoses in Italy: evaluation of 879 consecutive cases at the "Policlinico of Bari" teaching hospital in the period 1990-2009.
Ann Ist Super Sanita. 2014;50(1):44-8. doi: 10.4415/ANN_14_01_07.
4
The value of autopsies in the era of high-tech medicine: discrepant findings persist.在高科技医学时代，尸检的价值：存在差异的发现。
J Clin Pathol. 2014 Jun;67(6):512-9. doi: 10.1136/jclinpath-2013-202122. Epub 2014 Mar 4.
5
Is necropsy obsolete - an audit of the clinical autopsy over six decades: a study from Indian sub continent.尸检是否过时——对六十多年来临床尸检的审计：来自印度次大陆的一项研究
Indian J Pathol Microbiol. 2013 Oct-Dec;56(4):372-7. doi: 10.4103/0377-4929.125294.
6
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ASAIO J. 2014 Mar-Apr;60(2):207-10. doi: 10.1097/MAT.0000000000000031.
7
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8
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9
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10
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