尸检时的大脑：固定还是不固定？
Brains at necropsy: to fix or not to fix?
作者信息
Katelaris A, Kencian J, Duflou J, Hilton J M
机构信息
NSW Institute of Forensic Medicine, Glebe, Sydney, Australia.
出版信息
J Clin Pathol. 1994 Aug;47(8):718-20. doi: 10.1136/jcp.47.8.718.
AIM
To investigate whether routine formalin fixation of all brains coming to necropsy increases the rate of detection of brain abnormalities relative to either selective formalin fixation of brain tissue or fresh dissection of all brain tissue at the time of post mortem examination.
METHODS
A retrospective study of 300 medicolegal necropsies was performed. One hundred cases were examined by doctors with little or no formal training in necropsy pathology. One hundred cases were examined by forensic pathologists, who used their discretion as to whether to fix the brain in formalin. A further 100 cases were examined by neuropathologists; all the brains had already been fixed at the time of necropsy.
RESULTS
When examined by doctors with little or no formal necropsy pathology training, only 15% of brains were found to be abnormal. In the case of selective fixation, 33% were found to be abnormal. When there was obligatory fixation of all brains, 51% of all brains were found to be abnormal.
CONCLUSIONS
It is concluded that formalin fixation of the whole brain at the time of necropsy, followed by detailed examination of the brain by a neuropathologist, significantly increases the detection rate of brain pathology at necropsy.
目的
研究对于所有进行尸检的大脑，常规福尔马林固定相对于在尸检时对脑组织进行选择性福尔马林固定或新鲜解剖所有脑组织，是否能提高脑异常的检出率。
方法
对300例法医学尸检进行回顾性研究。100例由在尸检病理学方面几乎没有或没有正规培训的医生进行检查。100例由法医病理学家进行检查，他们自行决定是否将大脑用福尔马林固定。另外100例由神经病理学家进行检查；所有大脑在尸检时已被固定。
结果
由在尸检病理学方面几乎没有或没有正规培训的医生检查时，仅15%的大脑被发现异常。在选择性固定的情况下，33%被发现异常。当所有大脑都进行强制固定时，51%的大脑被发现异常。
结论
得出的结论是，尸检时对全脑进行福尔马林固定，随后由神经病理学家对大脑进行详细检查，可显著提高尸检时脑病理学的检出率。
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