胃肠道黏膜活检标本的前瞻性审计
Prospective audit of mucosal biopsy specimens of the gastrointestinal tract.
作者信息
Stephenson P M, Gallagher P J
机构信息
Department of Pathology, Southampton University Hospital.
出版信息
J Clin Pathol. 1995 Oct;48(10):936-8. doi: 10.1136/jcp.48.10.936.
AIMS
To determine why mucosal biopsy specimens of the gastrointestinal tract were taken and whether they were justified on clinical or pathological grounds.
METHODS
A prospective audit of 190 consecutive biopsy specimens received in a university hospital histology department over six weeks.
RESULTS
The 31 separate presenting symptoms included diarrhoea (34%), abdominal pain (16%) and rectal bleeding (15%). In 41% (78/190) the histology was normal, 28% (53/190) showed inflammatory changes and 11% 21/190) carcinoma. A clear justification for the procedure was identified in over 90% (171/190) of patients. In 36% (68/190) there was a change in patient management on receipt of biopsy reports and further investigations were ordered in 29% (55/190). The mean time taken to report biopsy specimens was 4.7 working days and there was no difference between the reporting time of a pathologist compared with a consultant or a trainee.
CONCLUSIONS
There is no evidence that mucosal biopsy specimens are taken unnecessarily.
目的
确定为何采集胃肠道黏膜活检标本，以及从临床或病理角度来看这些标本的采集是否合理。
方法
对一所大学医院组织病理科在六周内接收的190份连续活检标本进行前瞻性审计。
结果
31种不同的症状表现包括腹泻（34%）、腹痛（16%）和直肠出血（15%）。41%（78/190）的组织病理学检查结果正常，28%（53/190）显示有炎症变化，11%（21/190）为癌。在超过90%（171/190）的患者中确定了该检查的明确合理依据。36%（68/190）的患者在收到活检报告后改变了治疗方案，29%（55/190）的患者被安排了进一步检查。报告活检标本的平均时间为4.7个工作日，病理学家与顾问医生或实习医生的报告时间没有差异。
结论
没有证据表明黏膜活检标本的采集是不必要的。
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