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法医学杂志 2017, Vol. 33 Issue (6) :622-628    DOI: 10.3969/j.issn.1004-5619.2017.06.012
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颈内动脉系钝性损伤法医学鉴定现状
吴雪梅1,2,张更1,王琪3,倪自翔2,刘敏2,云利兵2,易旭夫2
(1. 福建医科大学基础医学院人体解剖与组织胚胎学系,福建 福州 350000; 2. 四川大学华西基础医学与法医学院法医病理教研室,四川 成都 610041; 3. 西安交通大学法医学院,陕西 西安 710061)
Current Status of Forensic Identification for Blunt Injuries of Internal Carotid Arterial System
WU XUE-MEI1,2, ZHANG GENG1, WANG QI3, NI ZI-XIANG2, LIU MIN2, YUN LI-BING2, YI XU-FU2
(1. Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Fujian Medical University, Fuzhou 350000, China; 2. Department of Forensic Pathology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu 610041, China; 3. College of Forensic Medicine, Xi’an Jiaotong University, Xi’an 710061, China)

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摘要 颈内动脉系是大脑的主要血供来源。法医学鉴定实践中,颈内动脉系钝性损伤后常出现血栓、动脉瘤或动静脉瘘等并发症,由此引起迟发性脑梗死、颅内出血死亡的案例并不少见。目前国内对颈内动脉系钝性损伤引起死亡的研究以个案报道为主,本文综合国内外相关的文献及案例报道,对此类损伤引起死亡的法医学特点及检查方法进行总结,发现颈内动脉系钝性损伤与头颈部直接暴力或间接暴力致头颈部超生理范围运动牵拉,以及颅底骨折切割等机制有关,多见于颈部机械性窒息、颈部按摩、车祸、高坠等案例。法医学实践中若遇到此类案例,常规检查未发现梗死或出血原因,应注意检查该动脉,正确分析外伤、疾病和死亡之间的关系。鉴于尸体解剖中完整暴露该动脉的难度较大,必要时可借助血管造影技术进行定位,提高鉴定意见的科学性和可靠性。
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吴雪梅
张更
王琪
关键词法医病理学   颈部损伤   综述   颈内动脉   血管造影术     
Abstract: Internal carotid arterial system is the main source of blood supply in brain. In forensic identification practice, blunt injures of internal carotid arterial system usually cause complications such as thrombus, aneurysm and arteriovenous fistula, etc. The deaths following delayed cerebral infarction or intracranial haemorrhage are not rare. At present, literature of deaths caused by blunt injuries of internal carotid arterial system mainly consist of case reports in China. This paper reviews related literature and case reports at home and abroad, and summarizes forensic medical features and identification method of the deaths caused by such injuries. The results show that blunt injures of internal carotid arterial system are related to the direct or indirect force on head and neck, which can result in exceed physiological range traction of head and neck, incision following basicranial fracture, etc. Such injuries are common in the cases as mechanical asphyxia, cervical manipulation, traffic accident and fall, etc. The artery should be examined carefully, and the relationship among injury, disease and death should be analysed correctly when no cause of infarction and hemorrhage was found in routine examination of such cases in forensic pratice. Because of the difficulty for exposing the artery completely in autopsy, angiography can be used to infer the location when necessary for improving the scientificity and reliability of the appraisal conclusion.
Keywordsforensic pathology   neck injuries   review   carotid artery, internal   angiography     
Corresponding Authors: 易旭夫,男,副教授,硕士研究生导师,主要从事法医病理学研究;E-mail:yixufu@tom.com   
About author: 吴雪梅(1990—),女,硕士,主要从事法医病理学研究;E-mail:sunshinecdpl@126.com
引用本文:   
吴雪梅, 张更, 王琪, 等.颈内动脉系钝性损伤法医学鉴定现状[J]  法医学杂志, 2017,33(6): 622-628
WU XUE-MEI, ZHANG GENG, WANG QI, DENG .Current Status of Forensic Identification for Blunt Injuries of Internal Carotid Arterial System[J]  , 2017,33(6): 622-628
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