Huston B M, Malouf N N, Azar H A
Department of Pathology, University of North Carolina, Chapel Hill, USA.
Mod Pathol. 1996 Dec;9(12):1101-7.
Despite the recognized advantages of a complete postmortem examination, autopsy rates continued to decline in recent decades. This study compares postmortem needle sampling to the complete, conventional autopsy to determine whether needle sampling is a viable alternative when consent for a complete autopsy is denied. A prospective study where postmortem percutaneous biopsies were obtained from the heart, the lungs, the liver, the kidney, and any other clinically relevant tissue or body fluid before the complete autopsy in 20 consecutive patients is presented. Cultures of the lungs, the spleen, and any other suspicious body fluid were also obtained. Liver and heart were recovered from all 20 of the patients, lung from 18 (90%), and kidney from 16 cases (80%). The cause of death was confirmed in 67% of the patients. Needle sampling correlated with the complete autopsy in 87% of the additional major diagnoses and with equally pertinent negative results. Postmortem needle lung cultures correlated with the complete autopsy in 17 (85%) of 20 patients and 16 (80%) of 20 spleen cultures. Cultures of the brain (one patient), cerebrospinal fluid (two patients), peritoneum (two patients), and serum (one patient) correlated 100% when compared to the complete autopsy. A complete autopsy is the goal of every postmortem examination. Postmortem "biopsies" can be an alternative option in certain situations and may be more acceptable to relatives of the deceased when consent for a complete autopsy is declined.
尽管完整尸检具有公认的优势，但近几十年来尸检率仍持续下降。本研究将尸检针吸采样与完整的传统尸检进行比较，以确定在拒绝进行完整尸检同意的情况下，针吸采样是否是一种可行的替代方法。本文介绍了一项前瞻性研究，对20例连续患者在进行完整尸检前，从心脏、肺、肝脏、肾脏以及任何其他临床相关组织或体液中获取尸检经皮活检样本。还获取了肺、脾和任何其他可疑体液的培养物。所有20例患者均获取了肝脏和心脏样本，18例（90%）获取了肺样本，16例（80%）获取了肾脏样本。67%的患者死亡原因得到确诊。在另外87%的主要诊断中，针吸采样结果与完整尸检结果相关，阴性结果也同样相关。20例患者中有17例（85%）的尸检针吸肺培养结果与完整尸检结果相关，20例脾培养中有16例（80%）相关。与完整尸检相比，1例患者的脑培养、2例患者的脑脊液培养、2例患者的腹膜培养和1例患者的血清培养结果100%相关。完整尸检是每次尸检的目标。在某些情况下，尸检“活检”可以作为一种替代选择，当拒绝完整尸检同意时，可能更容易被死者亲属接受。
