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法医学杂志 2018, Vol. 34 Issue (4) :384-388    DOI: 10.12116/j.issn.1004-5619.2018.04.008
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云南363例猝死案例的法医病理学分析
孙仲春,杨启琨,贾彭林,熊  鑫,瞿鹏飞,瞿勇强,雷普平
昆明医科大学法医学院,云南 昆明 650500
Forensic Pathology Analysis of 363 Sudden Death Cases in Yunnan Province
SUN Zhong-chun, YANG Qi-kun, JIA Peng-lin, XIONG Xin, QU Peng-fei, QU Yong-qiang, LEI Pu-ping
School of Forensic Medicine, Kunming Medical University, Kunming 650500, China

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摘要 目的 研究云南猝死(sudden death,SD)的流行病学及病理学特点,为猝死的防治和法医学鉴定提供科学依据。 方法 收集昆明医科大学司法鉴定中心2009—2017年尸体检验的363例猝死案例,回顾性分析其性别、年龄、发病到死亡时间、好发季节、死亡原因及诱因等猝死相关因素。 结果 猝死者男性多于女性,≥35~55岁年龄段为猝死高峰,发病后6 h内死亡率较高,各季节死亡人数从高到低分别为春季、夏季、冬季、秋季。导致猝死的前十位死亡原因依次为冠心病、不明原因猝死(sudden unexplained death,SUD)、脑出血、急性出血坏死性胰腺炎、主动脉夹层破裂、心肌病、肺炎、肺动脉血栓栓塞、羊水栓塞、过敏。运动,输液、手术、药物以及轻微损伤是冠心病猝死最常见的发病诱因,意识障碍或昏迷、胸痛或胸闷以及腹痛是冠心病猝死最常见的死亡前症状。 结论 中年男性猝死最常见,是猝死防治的重点人群。在法医学鉴定和猝死的防治中应对不明原因猝死给予重视。
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孙仲春
杨启琨
贾彭林
关键词法医病理学   猝死   死亡原因   冠心病   不明原因猝死     
Abstract: Objective To study the epidemiological and pathological features of sudden death (SD) in Yunnan Province and to provide scientific evidence for prevention and forensic identification of sudden death. Methods Totally 363 SD cases were collected from the autopsies between 2009 and 2017 in the Forensic Centre of Kunming Medical University. The related factors such as etiology, age, inducing factor, time interval between the onset of disease and death, morbidity season and pathological change were retrospectively analysed. Results The incidence of SD in males was significantly higher than that of females. The peak age was ≥35-55 years. The mortality rate was relatively high within 6 h after the onset of disease. The season order with descending number of deaths was spring, summer, winter and autumn. The top ten causes of SD were coronary heart disease, sudden unexplained death (SUD), cerebral hemorrhage, acute hemorrhagic necrotic pancreatitis, aortic dissection rupture, cardiomyopathy, pneumonia, pulmonary thromboembolism, amniotic fluid embolism and allergy. Exercise, infusion, surgery, medication and minor injury were the most common predisposing factors of sudden coronary death. Consciousness disorder or coma, chest pain or chest tightness, and abdominal pain were the most common premortem symptoms of sudden coronary death. Conclusion The SD is more common in middle-aged males, which is the key population for the prevention of SD. For the forensic identification and prevention of SD, the attention on SUD should be paid.
Keywordsforensic pathology   death, sudden   cause of death   coronary disease   sudden unexplained death     
Fund:国家自然科学基金资助项目(81460285);云南省科技厅与昆明医科大学应用基础研究联合专项资助项目(2013FB125, 2015FB007)
Corresponding Authors: 雷普平,男,副教授,主要从事法医病理学研究;E-mail:puping.jacky@qq.com   
About author: 孙仲春(1992—),男,硕士研究生,主要从事法医病理学研究;E-mail:957791581@qq.com
引用本文:   
孙仲春,杨启琨,贾彭林,等.云南363例猝死案例的法医病理学分析[J]  法医学杂志, 2018,34(4): 384-388
SUN Zhong-chun, YANG Qi-kun, JIA Peng-lin,et al..Forensic Pathology Analysis of 363 Sudden Death Cases in Yunnan Province[J]  法医学杂志, 2018,34(4): 384-388
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