智利大学临床医院的虚拟尸检项目或“virtuopsias”。是产生新知识和持续改进的重要环节。

Patricia Gómez M., María Elena Zúñiga G.
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引用次数: 0

摘要

当今医学进展的大部分医学知识都是基于19世纪进行的尸检发现和病理学研究。60年代末,由于多种原因,尸检在许多国家开始减少。如今,除非有合法的理由,否则几乎不再进行尸体解剖。如此重要和说教的病理解剖会议也不再举行了。这些实例发挥了特别重要的作用,将来自不同医学领域和学科的专家和学徒聚集在一起。不幸的是,他们已经从医院消失了。然而,医生似乎仍然需要它们,因为很多时候迫切需要获得有关患者症状的病因和导致他或她死亡的最终原因的可靠信息。在医疗保健和培训领域,这些信息对于产生新知识和提出新的诊断或治疗工具以持续改进的相关性是无可争议的。不幸的是,我们仍然面临这样的情况:病人在对最终死因有许多疑问的情况下死亡。在智利大学临床医院,几年来每周四都会召开所谓的不良事件会议。医生、助产士和护士组成的团队一步一步地分析所有报告的不良事件,他们花了很多时间试图阐明可能发生的事情,试图发现本可以纠正的错误。尽管如此,在某些情况下,一旦会议结束,怀疑仍然存在。目前在成像、免疫组织化学、分子和遗传研究技术方面的进步,使今天不需要传统的尸检就能获得最重要的信息成为可能。这些技术作为传统尸检的替代品出现,因为其中一些尸检研究的实现将有助于阐明许多诊断上的疑问,从而提高诊断水平。
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Programa de autopsias virtuales o “virtuopsias” en el Hospital Clínico Universidad de Chile. Un importante eslabón para la generación de nuevo conocimiento y mejoramiento continuo.
Most of today´s medical knowledge of current advances in medicine are based on autopsy findings and patological studies conducted during the 19th century. At the end of the 60s, autopsies began to decline in many countries, for multivariate reasons. Nowadays, autopsies are almost no longer performed unless legal reasons are present. The so important and didactic Pathological Anatomy Meetings are not being held anymore either. These instances played a particularly important role, bringing together and gathering experts and apprentices from different medical areas and disciplines. Unfortunately they have been disappearing from hospitals. However, physicians still seem to need them, as many times there is urgent need to get reliable information about the etiology of thepatients’ symptoms and the ultimate causes that led him or her to death. The relevance of this information for generating new knowledge and proposing new diagnostic or therapeutic tools for continuous improvement, both in the field of healthcare and training is indisputable. Unfortunately, we still face situations in which a patient dies in the midst of many doubts regarding the ultimate cause of death. At the University of Chile Clinical Hospital, a so-called Adverse Event Meetings have been held every Thursday for several years. A lot of time is spent trying to elucidate what could have happened, in an attempt to detect errors that could have been corrected A team of doctors, midwives and nurses, analyze all the adverse events reported, step by step. In spite of this, there are situations where doubts still persist, once the meeting is over. Currents advances in imaging, immune-histochemistry, molecular and genetic study techniques can make possible today to obtain most important information without the need for a traditional autopsy. These technologies, appear then as a substitute for traditional autopsies, since the realization of some of these post-mortem studies would allow to elucidate many diagnostic doubts, improving diagnostic.
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