南京军区南京总医院2055份病理切片外出会诊结果分析  

Analysis of 2055 consultation cases results from Jinling Hospital

作　　者：陆珍凤[1] 杜军[2] 夏春[1] 印洪林[1] 吴波[1] 石群立[1] 周晓军[1] 

机构地区：[1]南京军区南京总医院病理科,南京210002 [2]安徽省立医院南区病理科,合肥230036

出　　处：《医学研究生学报》2016年第3期299-301,共3页Journal of Medical Postgraduates

基　　金：南京军区医药卫生科研基金(2012-04-68)

摘　　要：目的各级医院病理科医师常会遇到较难明确诊断的病理切片,需要请上级医院或专科医院的病理医师会诊。文中比较南京军区南京总医院病理切片外出会诊的病理诊断与原病理诊断结果,分析2次诊断结果的分歧内容,以期为病理诊断的质量控制提供证据。方法收集南京军区南京总医院病理科2010年1月至2014年12月间病理切片外出会诊结果并进行统计,所有诊断至少由3位高级职称病理医师阅片,比较该会诊结果与原单位病理诊断结果的具体差异。结果会诊结论与原病理诊断结果完全一致共1813例(88.2%);诊断部分一致者218例(10.6%);而诊断完全不一致者24例(1.2%)。在完全不一致的成因中,缘于不同诊断单位信息不对等为37.5%,而由于组织取材以及对肿瘤分类、分期把握标准不一的比例分别达到29.2%和20.8%。结论外出会诊对疑难病例的病理诊断具有一定借鉴价值。通过详细问询病史、加强辅助检查以及积极组织会诊的方式可避免类似问题的发生。Objective When pathologists from hospitals at various levels encounters pathological sections diffcult to make clear diagosis,it is necessary to invite pathologists from higher hosiptals or special hospitals for pathologic consultation. In the study,we compared the pathological diagnosis of cases sent to other hospitals for pathological consultation with the original diagnostic result to analyze the differences by the evaluation on the impact of these differences on the treatment and prognosis of these patients,which would provide an effective evidence for the quality control of pathological diagnosis. Methods Cases initially diagnosed at the department of Nanjing General Hospital and later sent to other hospitals for pathological consultation from 2010 to 2014 were collected.All the diagnostic results were examined by at least 3 senior pathologists to find exact diffrences between consultation results and original diagnostic results. Results Among 2055 cases,it was found that there were 1813 cases（ 88. 2%） without diagnostic discrepancy,while 218 cases（ 10. 6%） with minor diagnostic discrepancy and 24 cases（ 1. 2%） with completely distinct diagnostic results.Conclusion The diagnostic results of the vast majority of consultation cases are in accordance with the original results,despite of diagnostic discrepancies in some cases due to the complexity of disease.Expert consultation has reference for the pathological diagnosis of complicated cases,which also plays a potent supervisory role on the quality control of original pathologic results.

关 键 词：会诊诊断 病例诊断 医疗质量 

分 类 号：R36[医药卫生—病理学]