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[脓毒症中最终临床诊断与尸检诊断的比较]

[Comparison of the final clinical and autopsy detected diagnoses in sepsis].

作者信息

Magrupov B A, Sharipova V Kh, Ubaydullaeva V U, Vervekina T A, Alimov A Kh, Rashidov D Z, Karimov A A, Kochetov V E

机构信息

Center for the Development of Professional Qualifications of Medical Workers, Tashkent, Republic of Uzbekistan.

Republican Scientific Center for Emergency Medical Care, Tashkent, Republic of Uzbekistan.

出版信息

Arkh Patol. 2022;84(4):38-44. doi: 10.17116/patol20228404138.

Abstract

UNLABELLED

With sepsis, more than a third of patients die, while the immediate causes of death may remain unknown. Autopsy largely helps to establish them.

OBJECTIVE

Identification of discrepancies in the final clinical and autopsy detected diagnoses in patients with sepsis who died in the surgical intensive care unit.

MATERIAL AND METHODS

107 cases of patients with sepsis who died in the Department of Surgical Resuscitation of the Republican Scientific Center for Emergency Medical Care in 2020-2021 were studied. Autopsy was performed in 60 (56%) of the deceased. The autopsy was performed within 24 hours after the death was pronounced. The final clinical and pathoanatomic diagnoses were compared in accordance with the International Goldman System and the Russian Classification of categories of diagnosis discrepancies.

RESULTS

As a result of autopsies, 3 (5%) of the deceased had a discrepancy in the diagnoses of class I and 14 (23%) - class II according to the International Goldman System. During his lifetime, diseases or their complications were not recognized in 17 (28%) cases, mainly acute myocardial infarction of type 2 (3 cases) and liver abscesses (3 cases).

CONCLUSION

A pathoanatomic autopsy is a modern and important diagnostic tool that can clarify the causes of death.

摘要

未标注

在脓毒症患者中,超过三分之一的患者死亡,而直接死因可能仍然不明。尸检在很大程度上有助于确定死因。

目的

识别在外科重症监护病房死亡的脓毒症患者最终临床诊断与尸检诊断之间的差异。

材料与方法

研究了2020 - 2021年在共和国紧急医疗护理科学中心外科复苏科死亡的107例脓毒症患者。60例(56%)死者进行了尸检。在宣布死亡后24小时内进行尸检。根据国际戈德曼系统和俄罗斯诊断差异分类对最终临床诊断和病理解剖诊断进行比较。

结果

根据国际戈德曼系统,尸检结果显示,3例(5%)死者的诊断为I类差异,14例(23%)为II类差异。在17例(28%)病例中,生前未识别出疾病或其并发症,主要是2型急性心肌梗死(3例)和肝脓肿(3例)。

结论

病理解剖尸检是一种现代且重要的诊断工具,可明确死因。

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