经皮穿刺穿刺尸检的实践一项描述性研究报告了乌干达的经验。

Q2 Medicine
BMC Clinical Pathology Pub Date : 2014-12-03 eCollection Date: 2014-01-01 DOI:10.1186/1472-6890-14-44
Janneke A Cox, Robert L Lukande, Sam Kalungi, Koen Van de Vijver, Eric Van Marck, Ann M Nelson, Asafu Munema, Yukari C Manabe, Robert Colebunders
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引用次数: 22

摘要

背景:经皮穿刺尸检可以克服一些限制使用完整尸检的障碍。我们在乌干达对感染艾滋病毒的成年人进行了盲法和超声引导下的针头尸检。在这项研究中,我们详细描述了我们使用的方法,两种方法获得足够组织以供进一步检查的能力以及操作员随时间的学习曲线。方法:如果获得近亲属的书面知情同意,我们首先进行盲针尸检,使用预定义的表面标记点刺穿脑、心、肺、肝、脾和肾。然后我们进行了超声引导下穿刺心脏、肝脏、脾脏和肾脏的尸检。注意到尝试次数、预期成功和程序持续时间。病理学家阅读载玻片,并指出目标组织是否存在,是否有足够的质量进行病理检查。我们报告了预测和真实的成功率,比较了盲针活检和超声引导下的针活检的成功率,并评估了失败率。结果:2名操作人员进行盲针解剖96例,超声引导下穿刺95例。盲针活检的真实成功率在56-99%之间,预测成功率在89-99%之间。超声引导下穿刺活检的真实成功率为72-100%,预测成功率为84-98%。超声引导下心脏和左肾移植成功率显著提高。随着时间的推移,观察到一个学习曲线,失败率随着经验的增加和针头解剖时间的缩短而降低。结论:在绝大多数情况下,针刺尸检都能成功获取组织进行进一步的病理检查,且失败率随着操作者经验的增加而降低。超声引导的益处将取决于人口、疾病和感兴趣的器官以及当地情况。我们的结果证明进一步评估针头尸检作为一种确定死因的方法是合理的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Practice of percutaneous needle autopsy; a descriptive study reporting experiences from Uganda.

Practice of percutaneous needle autopsy; a descriptive study reporting experiences from Uganda.

Background: Percutaneous needle autopsy can overcome a number of barriers that limit the use of complete autopsies. We performed blind-and ultrasound guided needle autopsies in HIV-infected adults in Uganda. In this study we describe in detail the methods we used, the ability of both procedures to obtain sufficient tissue for further examination and the learning curve of the operators over time.

Methods: If written informed consent was granted from the next of kin, we first performed a blind needle autopsy, puncturing brain, heart, lungs, liver, spleen and kidneys using predefined surface marking points. We then performed an ultrasound guided needle autopsy puncturing heart, liver, spleen and kidneys. The number of attempts, expected success and duration of the procedure were noted. A pathologist read the slides and indicated if the target tissue was present and of sufficient quality for pathological review. We report the predicted and true success rates, compare the yield of blind to ultrasound guided needle biopsies and evaluate the failure rate over time.

Results: Two operators performed 96 blind needle autopsies and 95 ultrasound guided needle autopsies. For blind needle biopsies true success rates varied from 56-99% and predicted success rates from 89-99%. For ultrasound guided needle biopsies true success rates varied from 72-100% and predicted success rates from 84-98%. Ultrasound guidance led to a significantly higher success rate in heart and left kidney. A learning curve was observed over time with decreasing failure rates with increasing experience and a shorter duration of the needle autopsy.

Conclusion: Needle autopsy can successfully obtain tissue for further pathological review in the vast majority of cases, with a decrease in failure rate with increasing experience of the operator. The benefit of ultrasound guidance will depend on the population, the disease and organ of interest and the local circumstances. Our results justify further evaluation of needle autopsies as a method to establish a cause of death.

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来源期刊
BMC Clinical Pathology
BMC Clinical Pathology Medicine-Pathology and Forensic Medicine
CiteScore
3.30
自引率
0.00%
发文量
0
期刊介绍: BMC Clinical Pathology is an open access journal publishing original peer-reviewed research articles in all aspects of histopathology, haematology, clinical biochemistry, and medical microbiology (including virology, parasitology, and infection control). BMC Clinical Pathology (ISSN 1472-6890) is indexed/tracked/covered by PubMed, CAS, EMBASE, Scopus and Google Scholar.
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