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尸检:其式微与复兴之建议。

The autopsy: its decline and a suggestion for its revival.

作者信息

Roberts W C

出版信息

N Engl J Med. 1978 Aug 17;299(7):332-8. doi: 10.1056/NEJM197808172990704.

Abstract

The hospital autopsy rate in the United States dropped from 41 per cent in 1964 to 22 per cent in 1975. This reduction is attributable to a declining interest for many reasons by clinicians, surgeons, pathologists, families of the deceased and hospital administrators and hospital accreditors. Various advances in medicine and surgery in recent years have not replaced the value of the autopsy; indeed they have increased the potential information to be gained from it. For interest in autopsies to be revived among physicians and surgeons, pathologists must provide more expert information from the autopsy. To provide the type of information sought from autopsies by physicians and surgeons, the training of pathologists must be altered so that there can be more specialization in anatomic pathology and more subspecialization in the various organ systems, as in internal medicine. In addition, the means of communication between anatomic pathologists and clinicians needs altering so that important clinical questions are recognized by pathologists, and the answers sought and promptly, understandably and diplomatically communicated to physicians and surgeons. Moreover, the large body of information obtained in recent years from autopsies alone needs to be better recognized by clinicians so that they may better understand the value of these examinations.

摘要

美国医院的尸体解剖率从1964年的41%降至1975年的22%。这种下降归因于临床医生、外科医生、病理学家、死者家属、医院管理人员以及医院评审机构出于多种原因而日益减少的兴趣。近年来医学和外科的各种进展并未取代尸体解剖的价值;事实上,这些进展增加了从尸体解剖中可获得的潜在信息。为了使内科医生和外科医生重新对尸体解剖产生兴趣,病理学家必须从尸体解剖中提供更多专业信息。为了提供内科医生和外科医生从尸体解剖中寻求的那种信息,必须改变病理学家的培训方式,以便在解剖病理学方面能够有更多的专业化,并且在各个器官系统方面能够有更多的亚专业化,就像在内科医学中一样。此外,解剖病理学家与临床医生之间的沟通方式需要改变,以便病理学家能够认识到重要的临床问题,并将所寻求的答案及时、易懂且得体地传达给内科医生和外科医生。而且,近年来仅从尸体解剖中获得的大量信息需要临床医生更好地认识到,以便他们能够更好地理解这些检查的价值。

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