临床诊断与尸体检验相关性研究184例尸体解剖-第三军医大学学报.doc

临床诊断与尸体检验诊断相关性研究：356例尸体解剖资料分析 段晋琦，李剑波，闫伟，朱素敏，宋安林（重庆医科大学法医教研室，重庆，400016） 摘 要： 目的 比较临床诊断与尸体检验诊断结果，分析评估临床误诊率。方法 回顾分析重庆医科大学法医教研室1988-2007年医疗纠纷尸体解剖356例，统计内容包括病人的性别、年龄、病人在医院的时间、科别，死亡疾病和医院的等级、比较尸体检验诊断与临床诊断的一致率。结果 临床诊断与尸检诊断完全一致的有162例（占45.5%），临床诊断与尸检诊断不一致的有101例（占28.4%），临床诊断与尸检诊断部分不一致的有63例（占17.7%），无法比较的有30例（占8.4%）。误诊率最高的是循环系统和呼吸系统疾病，其中心肌病，主动脉粥样硬化与高血压至主动脉破裂，肺炎的误诊率最高。结论 尸体检验是提高医疗质量的一个重要因素，积极开展尸检十分必要。 关键词： 尸体解剖；临床诊断；病理学 中图法分类号：R322，R543，R89 文献标识码：A Retrospective Study of Clinical Diagnoses and autopsy :An Analyses of 356 cases DuanJinqi，Liianbo ，YanWei，Zhuumin，Songnlin（Chong ing University of Medical Sciences Department of Forensic，Chongqing 400016,China） AbstractObjective To compare the clinical diagnoses with autopsy findings and evaluate the frequency of diagnostic errors. Methods Retrospective analysis of the protocols of 356 cases of medical treatment dispute autopsied in the Department of Forensic Medicinal of Chongqing medical university during the period 1988-2007. The outcome measures included concordance between diagnosis before death and at autopsy, sex, age, length of hospitalization of the patient hospital administrative, distribution of death disease and the rank of hospital. Results In 162 cases(45.5%), the autopsy 通讯作者：李剑波，男，博士，教授，硕士生导师，重庆医科大学法医教研室主任，主要从 事法医病理，物证，临床法医的研究，联系电话：023E-mail：ljb2032003@ 收稿日期：2008-9-27 findings confirmed the clinical diagnosis. In 101 cases(28.4%), the clinical diagnosis suggested by the clinicians were discordant with the autopsy findings. In 63 cases (17.7%), several diagnoses were suggested by the clinicians, and in 30 cases(8.4%), the comparison between clinical and postmortem diagnosis was not possible. The most frequently misdiagnosed diseases were cardiomyopathy,aorta bursts,pneumonia.. Conclusion autopsy evaluation is necessary to improve the quality of patient care. key words： autopsy ； clinical diagnoses； pathology 第一作者：段晋琦，女，硕士，联系电话E-mail：hongxiadjq@126.com 近年来，我国医疗水平在不