地市级医院292例远程病理会诊病例分析  

Analysis of 292 cases of telepathology consultation in a city-level hospital

作　　者：张雨涛[1] 周洪园 唐云[1] 邹燕丽[1] 李红[1] 

机构地区：[1]四川省自贡市第一人民医院病理科,643000

出　　处：《临床与实验病理学杂志》2016年第1期64-67,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨远程病理会诊在帮助解决地市级医院疑难病理诊断和病理质量控制问题中的应用价值。方法回顾292例远程病理会诊病例,分析会诊病例的系统分布特点,计算远程病理会诊确诊率及获得报告的时长等指标,评价远程病理会诊在帮助解决基层医院病理科疑难病理诊断与质量控制中的应用价值。结果会诊病例中占前五位的分别是妇产科(62/292、21.23%)、软组织(34/292、11.64%)、淋巴造血系统(26/292、8.90%)、呼吸系统(19/292、6.51%)、皮肤(18/292、6.16%)。会诊病例最快可在30 min内获得会诊报告,88.7%(259/292)的病例可在48 h内获得会诊报告,获得会诊报告的平均时长约12 h。292例远程病理会诊病例的总体确诊率为90.07%(263/292),其中首次会诊的确诊率为69.86%(204/292);20.2%(59/292)的病例接受专家建议进行免疫组化或特殊染色检测,经检测后均获得确诊;仅有0.34%(1/292)的病例经多点会诊后仍存在良恶性诊断分歧。结论远程病理会诊可提供准确、及时的专家咨询病理报告,帮助提高基层医院病理诊断水平,值得在基层医院病理科推广应用。建设和发展区域远程病理会诊平台是一个新的病理质量控制发展方向。Purpose To study the applied value of telepathology consultation on the resolve of complicated pathologic diagnosis and the improvement of pathologic quality control for city-level hospitals. Methods Retrospective analysis was performed for 292 cases of telepathology consultation finished in department of pathology of Zigong First People＇ s Hospital. Distribution status of telepathology consultation cases for anatomical system was analyzed. Both ratio of obtaining final diagnosis and time spended on telepathology consultation were calculated. The applied value of telepathology consultation helped to solve problem on complicated pathologic diagnosis and pathologic quality control for primary hospitals was also estimated. Results Telepathology consultation cases were mainly distributed in five aspects, including gynaecology and obstetrics （62/292, 21.23% ） , soft tissue （34/292, 11.64% ） , haematopoietie and lymphoid tissue （26/292, 8. 90% ） , respiratory system （19/292, 6. 51% ） and skin （18/292, 6. 16% ）. It took no more than 30 minutes for one of the cases to obtain the consultation report and no more than 48 hours for 88.7% （259/292） of the cases to obtain the consultation report on the whole. Average time limit of one consultation report was about 12 hours. Total ratio of final diagnosis for 292 cases of telepathology consultation was 90. 07% （263/292）. Among all the cases for consultation, 69. 86% （204/292） of the cases could be diagnosed by the experts in one time, and immnnohistochemistry or histoehemistry detection were performed on 20. 2% （59/292） of the cases according to the advice from experts. After detection, all the cases could be definitely diagnosed. For only one case （ 1/292, 0. 34% ）, there were different benign or malignant consultation opinions from several experts. Conclusion The patients can obtain precise and prompt consultation reports from the experts through telepathology consultation and it also can help to improve diagnostic level of pathology

关 键 词：远程病理 会诊 

分 类 号：R365[医药卫生—病理学]