法医学杂志

法医学杂志 ›› 2012, Vol. 28 ›› Issue (6): 432-434.DOI: 10.3969/j.issn.1004-5619.2012.06.008

• 案例分析 • 上一篇    下一篇

21例主动脉夹层死亡引发纠纷案例分析

杨嵩民1，2，张广政1   

  1. （1. 郑州大学基础医学院法医学教研室，河南 郑州 450052； 2. 登封市公安局刑侦支队，河南 郑州 452470）
  • 发布日期:2012-12-25 出版日期:2012-12-28
  • 通讯作者: 张广政，男，博士，副教授，主要从事法医病理学、法医临床学和司法精神病学研究；E-mail：zgz@zzu.edu.com
  • 作者简介:杨嵩民（1971—），男，河南登封人，硕士研究生，主检法医师，主要从事法医病理损伤学、医疗纠纷的司法鉴定；E-mail：songminyang@126.com

Analysis of 21 Autopsy Cases of Aortic Dissection with Disputes

YANG SONG-MIN1,2, ZHANG GUANG-ZHENG1   

  1. （1. Department of Forensic Medicine, College of Basic Medical Science, Zhengzhou University, Zhengzhou 450052, China; 2. Criminal Investigation Detachment, Dengfeng Public Security Bureau, Zhengzhou 452470, China）
  • Online:2012-12-25 Published:2012-12-28

被引次数

8

摘要： 目的 探讨对引发纠纷的涉及主动脉夹层死亡病例进行法医学鉴定的程序和方法。 方法 收集某机构2006—2011年涉及主动脉夹层死亡法医学鉴定案件21例，分析此类案件的发生原因、特点。 结果 21例中引发纠纷的原因多为临床误诊或生前遭受轻微暴力；在各例的病理分型中De Bakey Ⅰ型和Ⅱ型（或Stanford A型）居多；在此类案件的鉴定中，寻找夹层的内膜和外膜破裂口、观察血管壁分层形态十分重要。 结论 经验不足、观察不严密和就诊过程仓促是漏诊主动脉夹层的主要原因，对损伤和疾病关系以及原发病和并发症之间关系的把握是本类鉴定的难点。

关键词: 法医病理学, 主动脉夹层, 纠纷

Abstract: Objective To explore procedures and methods of forensic investigation for the death cases of aortic dissection with disputes. Methods Twenty-one death cases of aortic dissection with disputes from 2006 to 2011 were collected. All the data were analyzed to investigate the reasons and features of the disputes. Results The main causes of the disputes were clinical misdiagnosis or slight force. The pathologic type of De Bakey （Ⅰ and Ⅱ） or Stanford A were common in each case. For the cases dying of aortic dissection, it was significantly important to detect the rupture of entry and exit and observe the dissection of arterial wall. Conclusion The main causes of clinical misdiagnosis are insufficient experiences, careless observation and curtness in medical treatment. The difficult points in these cases are confirmation of the relationships between injury and disease, the primary affection and complication.

Key words: forensic pathology, aortic dissection, dispute

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