578例术中快速远程病理会诊的分析与体会  

Analysis and experience of 578 cases of intraoperative telepathology consultation

作　　者：袁静萍[1] 唐其柱[2] 徐春灵[3] 阎红琳 谭新平 夏良兵 吕鸣 何子强 郅熙龙 刘新权[3] Yuan Jingping;Tang Qizhu;Xu Chunling;Yan Honglin;Tan Xinping;Xia Liangbing;Lyu Ming;He Ziqiang;Zhi Xilong;Liu Xinquan(Department of Pathology, Renmin Hospital of Wuhan University, Wuhan 430060, China;Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China; Department of Pathology, Fifth Division Hospital of Xinjiang Production and Construction Corps, Bole 833400, China;Department of Pathology, Renmin Hospital of Jianli County, Jianli 433300, China;Department of Pathology, Renmin Hospital of Yings han County, Yings han 438700, China;Department of Pathology, Renmin Hospital of Xiaochang County, Xiaochang 432900, China;Beijing Yi He Yun Chuang Technology Co., Ltd, Beijing 100000, China)

机构地区：[1]武汉大学人民医院病理科,430060 [2]武汉大学人民医院心血管内科,430060 [3]新疆生产建设兵团第五师医院病理科,博乐833400 [4]监利县人民医院病理科,荆州433300 [5]英山县人民医院病理科,黄冈438700 [6]孝昌县人民医院病理科,孝感432900 [7]北京义和云创科技有限公司,100000

出　　处：《中华内分泌外科杂志》2018年第6期502-506,共5页Chinese Journal of Endocrine Surgery

基　　金：武汉市科技计划项目(2017060201010172);第五师双河市科技计划项目(16YW01).

摘　　要：目的探讨快速远程病理会诊在帮助解决基层医院中的应用价值。方法回顾578例术中快速远程病理会诊病例,计算诊断的准确率和及时率,分析会诊病例的系统分布、良恶性分布及在不同基层医院的分布差异,评价快速远程病理会诊的推广价值。结果578例术中快速会诊病例的诊断准确率为99.83%。会诊病例在30min内获得会诊报告的及时率为96.02%,大多数报告可在2~5min内完成诊断。会诊病例涉及的组织来源主要为甲状腺、乳腺、卵巢/输卵管与肺。所有病例中恶性肿瘤占比24.39%。在不同系统的疾病中,乳腺疾病中的恶性肿瘤比例最高,其次是肺、甲状腺和卵巢。在会诊量较大的4家基层医院中,监利县人民医院的术中快速恶性肿瘤比例最高,其次是英山县人民医院、孝昌县人民医院、新疆第五师医院。结论术中快速远程病理会诊可为基层医院提供准确、及时的专家咨询病理报告,避免了患者的"二进宫",提升了基层百姓就医获得感,解决基层病理医师不足的现状,同时提高基层医院医生的诊治水平,值得在基层医院病理科推广和应用。Objective To explore the application value of telepathological consultation in helping grassroots hospitals. Methods 578 cases of intraoperative telepathology consultation were reviewed, and the accuracy and the timely rate of diagnosis were calculated. The systematic distribution, benign and malignant distribution, and the distribution difference in different primary hospitals were analyzed, so as to evaluate the popularization value of the intraoperative telepathology consultation. Results The accuracy rate of 578 cases of intraoperative telepathology consultation was 99.83%. The timely rate of consultation in 30min was 96.02%, and most reports could be diagnosed in 2 to 5 mins. The source of tissues involved in consultation were thyroid, breast, ovary/fallopian tube and lung. In all cases, 24.39% of the malignant tumors were found. Among the diseases of different systems, the proportion of malignant tumors is the highest in breast diseases, followed by lung, thyroid and ovary. Among the four hospitals with most of the consultations, the rate of malignant tumor in Renmin Hospital of Jianli County was the highest, followed by Renmin Hospital of Yingshan County, Renmin Hospital of Xiaochang County, and Fifth Division Hospital of Xinjiang. Conclusion Intraoperative telepathology consultation can provide accurate and timely expert consultation for grassroots hospitals, avoid the "second operations" of the patients, improve the access of medical treatment for people living in relatively remote areas, solve the shortage of pathologists at the grassroots hospitals, and improve the level of doctors' diagnosis and treatment at the grassroots hospitals, which is worth popularizing and applying in Pathology Department of the grassroots hospitals.

关 键 词：远程会诊 术中快速 病理 分级诊疗 

分 类 号：R-05[医药卫生]