Boldy D A, Jones C, Matthews H, Edwards C
Department of Respiratory Medicine, East Birmingham Hospital, Bordesley Green East.
Thorax. 1993 Mar;48(3):284-6. doi: 10.1136/thx.48.3.284.
There is concern about the decrease in the number of requests for necropsies, so a study was undertaken to assess current clinical practice.
A prospective study was made of all deaths occurring under the care of five chest physicians and three thoracic surgeons at East Birmingham Hospital from 1 April to 30 June 1989.
A necropsy was sought in 34 of 58 deaths (59%) and was performed in 22 instances (38%). Major unexpected findings which would have affected clinical management were noted in three patients (14%). The mean delay in reporting results of histological examinations was 146 days (range 41-260 days). As the result of an increase in pathology technical staff levels and alteration in the practice of processing histological data, there was a substantial improvement during the corresponding period in 1990 (mean reduction 58 days, 95% confidence limits 39-77 days). Apart from patients with histologically proved carcinoma, there was no consistent pattern for requests for necropsies.
Necropsies continue to reveal diagnoses which were not suspected while the patient was alive. Although the number of requests made by clinical staff for necropsies is reasonable, the reasons for the requests are not consistent. Guidelines are suggested to improve the number of successful requests and to maximise the information obtained from them.
人们对尸检申请数量的减少感到担忧，因此开展了一项研究以评估当前的临床实践情况。
对1989年4月1日至6月30日在东伯明翰医院由5名胸科医生和3名胸外科医生负责治疗期间发生的所有死亡病例进行了一项前瞻性研究。
58例死亡病例中有34例（59%）申请了尸检，其中22例（38%）进行了尸检。在3例患者（14%）中发现了可能会影响临床治疗的重大意外发现。组织学检查结果报告的平均延迟时间为146天（范围41 - 260天）。由于病理技术人员数量增加以及组织学数据处理方式的改变，1990年同期有了显著改善（平均减少58天，95%置信区间39 - 77天）。除了经组织学证实为癌症的患者外，尸检申请没有一致的模式。
尸检仍能揭示患者生前未被怀疑的诊断。尽管临床工作人员提出的尸检申请数量合理，但申请的原因并不一致。建议制定指导方针以增加成功申请的数量，并最大限度地从尸检中获取信息。
