Running a postmortem service - a business case and clinical experience
Running a postmortem service - a business case and clinical experience
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DOI：
10.1007/s00247-014-3156-0
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发表时间：
2015-04-01
影响因子：
2.3
通讯作者：
Offiah, Amaka C.
中科院分区：
文献类型：
--
作者：
Cohen, Marta C.;Whitby, Elspeth;Offiah, Amaka C.
验尸的目的是提供解释死因和死亡方式的答案。在围产期、婴儿和儿科尸检检查的情况下，目标是确定未预料到的相关特征，描述致病机制和新情况，并评估临床管理和诊断。此外，验尸检查有助于向家庭咨询未来怀孕复发的可能性，并为计划生育提供信息。在过去几十年里，世界范围内的儿科尸检检查率显著下降。在英国，宗教对死后解剖的反对和器官保留丑闻为寻找传统解剖的非侵入性替代方案提供了一些动力；然而，直到最近，影像学研究仍然是传统尸检的辅助手段，而不是替代手段。2012年，谢菲尔德儿童医院国家卫生服务基金会信托设立了微创胎儿、围产期和新生儿尸检服务，而自2008年以来，澳大利亚墨尔本一直在提供尸检成像服务。在这里，我们总结了一个商业案例的要点，以及英国和澳大利亚在病理学和放射学方面建立微创临床服务的实际经验，以及在澳大利亚发展临床死后成像服务作为传统尸检的补充工具。
The purpose of the postmortem examination is to offer answers to explain the cause and manner of death. In the case of perinatal, infant and paediatric postmortem examinations, the goal is to identify unsuspected associated features, to describe pathogenic mechanisms and new conditions, and to evaluate the clinical management and diagnosis. Additionally, the postmortem examination is useful to counsel families regarding the probability of recurrence in future pregnancies and to inform family planning. Worldwide the rate of paediatric autopsy examinations has significantly declined during the last few decades. Religious objections to postmortem dissection and organ retention scandals in the United Kingdom provided some of the impetus for a search for non-invasive alternatives to the traditional autopsy; however, until recently, imaging studies remained an adjunct to, rather than a replacement for, the traditional autopsy. In 2012, Sheffield Children's Hospital National Health Service Foundation Trust set up the service provision of minimally invasive fetal, perinatal and neonatal autopsy, while a postmortem imaging service has been running in Melbourne, Australia, since 2008. Here we summarise the essentials of a business case and practical British and Australian experiences in terms of the pathological and radiologic aspects of setting up a minimally invasive clinical service in the United Kingdom and of developing a clinical postmortem imaging service as a complementary tool to the traditional autopsy in Australia.