法医学杂志

法医学杂志 ›› 2023, Vol. 39 ›› Issue (6): 571-578.DOI: 10.12116/j.issn.1004-5619.2022.220707

• 案例分析 • 上一篇    

18例输卵管妊娠相关医疗损害法医学鉴定分析

李影1(), 俞勇2, 寇兴华1, 韩占龙1()   

  1. 1.北京华夏物证鉴定中心，北京 100089
    2.北京法源司法科学证据鉴定中心，北京 100062
  • 收稿日期:2022-07-19 发布日期:2024-01-17 出版日期:2023-12-25
  • 通讯作者: 韩占龙
  • 作者简介:李影（1982—），女，主检法医师，主要从事法医学鉴定；E-mail：hxly139@163.com

Forensic Analysis of Eighteen Tubal Pregnancy-Related Medical Damage

Ying LI1(), Yong YU2, Xing-hua KOU1, Zhan-long HAN1()   

  1. 1.Beijing Huaxia Evidence Identification Center, Beijing 100089, China
    2.Beijing Source of Judicial Identification Center of Scientific Evidence, Beijing 100062, China
  • Received:2022-07-19 Online:2024-01-17 Published:2023-12-25
  • Contact: Zhan-long HAN

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摘要：

目的 分析输卵管妊娠误诊后发生医疗损害的案例，探讨发生医疗损害的原因，过错行为与损害后果的因果关系以及原因力大小，为此类案件的法医学鉴定提供评价思路。 方法 收集18例输卵管妊娠相关医疗损害的法医学鉴定案件，从患者年龄、孕产史、生育需求、危险因素、诊疗情况、医疗过错、损害后果、原因力大小等方面进行回顾性分析。 结果 18例均为输卵管妊娠，其中17例医疗行为存在过错，导致14例患侧输卵管切除，2例失血性休克死亡，1例宫内胎儿停止发育并患侧输卵管切除。另1例虽有输卵管切除的损害后果，但医疗行为无过错。 结论 正确的诊断有助于制定合理的治疗方案，防止病情进展，减少严重不良后果和医患纠纷的发生。科学、合理地分析医疗过错行为与损害后果之间的因果关系及原因力大小，对此类医患纠纷的顺利解决有重要意义。

关键词: 法医学, 输卵管妊娠, 复合妊娠, 医疗损害, 输卵管切除术, 辅助生殖技术, 案例分析

Abstract:

Objective To analyze the cases of medical damage after misdiagnosis of tubal pregnancy, to explore the causes of medical damage, the causal relationship between medical malpractice and the damage consequences, as well as the causative potency, in order to provide evaluation ideas for forensic identification of such cases. Methods Eighteen cases of forensic identification of tubal pregnancy related medical damage were collected and retrospectively analyzed from the aspects of age, maternity history, fertility requirements, risk factors, diagnosis and treatment, medical malpractice, damage consequences, and causative potency. Results All 18 cases were tubal pregnancy, of which 17 cases had medical malpractice, resulting in 14 cases of affected tubal resection, 2 cases of hemorrhagic shock death, 1 case of intrauterine fetal death and affected tubal resection. The other case had the consequence of affected tubal resection, but there was no malpractice in the treatment. Conclusion Correct diagnosis is helpful to make appropriate treatment plan, prevent disease progression and reduce serious adverse consequences and the occurrence of medical disputes. Scientific and reasonable analysis of the causal relationship between medical malpractice and damage consequences and the causative potency is of great significance to the successful settlement of medical disputes.

Key words: forensic medicine, tubal pregnancy, heterotopic pregnancy, medical damage, salpingectomy, assisted reproductive technology, case analysis

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