猝死致医疗纠纷269例临床病理分析  

Medical dispute and sudden death:a clinicopathologic analysis of 269 cases

作　　者：刘伟强[1] 冯菲[2] 白辰光[1] 朱明华[1] 

机构地区：[1]第二军医大学附属长海医院病理科,上海200433 [2]上海市杨浦区疾病预防控制中心体检科,200433

出　　处：《临床与实验病理学杂志》2009年第3期274-277,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的分析猝死致医疗纠纷的原因、特点及疾病分布。方法收集涉及医疗纠纷的猝死尸检病例269例，进行病理组织学检查，部分做了法医学的毒物分析。结果269例中男性明显多于女性且高发年龄段为15—60岁。其死亡原因以心血管系统疾病占首位，但其中以肺栓塞多见；其下依次为消化系统疾病、呼吸系统疾病、中枢神经系统疾病、泌尿生殖系统疾病和一些其它系统（如内分泌、免疫等）疾病。病例多发生于二、三级医院且临床与病理诊断符合率偏低。结论引起医疗纠纷的主要原因是未能对致死疾病作出准确的诊断和合理解释，而尸体解剖对于明确死亡原因及准确鉴定医疗纠纷具有重要意义。另外，引起医疗纠纷的猝死病例在年龄、性别和死因的疾病分布方面有其特殊性。Purpose To analyze the cause, characteristics and distribution of diseases of sudden-death in medical disputes. Methods 269 autopsy cases of sudden death associated with medical disputes were collected and analyzed by histopathologie examinations, some of which were toxicologically detected by forensic methods. Results Among the 269 cases, the male was significantly higher than female, and the high risk population was from 15 to 60 years old. Cardiovascular system diseases were the most eommon diseases, in which the lung embolism was the most common, followed by the diseases of digestive system, respiratory system, central nerve system, urogenital system, and other systems（ such as endocrine and immune system）. Most of the cases happened in the hospital. The coincidence rate between the clinical and pathological diagnosis was low. Conclusions The main cause of medical disputes is deficient in exact diagnosis and adequate explanation. Autopsy is of great importance in identifying the death causes and authenticating medical issues. The age and the distribution of diseases have specific significance in the sudden death cases leading to medical disputes.

关 键 词：猝死 医疗纠纷 尸体解剖 

分 类 号：R541[医药卫生—心血管疾病]