193例医疗纠纷案例的法医病理学分析  

Analysis of 193 Forensic Autopsy Cases of Medical Tangle

作　　者：张岑岑[1] 许光亚[1] 龚道银[1] 王耀宾[1] 黄飞骏[1] 

机构地区：[1]四川大学华西基础医学与法医学院法医病理教研室,成都610041

出　　处：《华西医学》2010年第4期740-742,共3页West China Medical Journal

摘　　要：目的探讨医疗纠纷死亡案例的法医病理学特点,强调尸检对于解决医疗纠纷的重要性。方法对四川华西法医学鉴定中心2002年1月-2008年12月193例医疗纠纷案件中死亡案例进行回顾性统计研究分析。结果①男性多于女性,10岁以下儿童及20～60岁中青年人群所占比例较其他年龄组高;②纠纷医院、科室多见于二级医院和外科;③尸检案例中,临床诊断死因不明者41例,临床诊断和法医病理死因诊断符合率74.8%。法医病理检验查明死因者139例,未发现明确死因者13例。死因明确的案例中,病理性死亡118例,以心血管系统疾病死亡最多见,非病理性死亡21例;④136所医院医疗过程中存在过失行为,以二级医院比例最大。医疗过失行为以技术过失居多,其次为责任过失。结论尸检对于医疗纠纷的鉴定具有重要价值,医院在加强自身建设的同时需提高对尸检的认识。Objective To discuss the characteristics of deaths in medical tangles to emphasize the importance of autopsy.Methods 193 forensic autopsy cases of medical tangles during January 2002 to December 2008 from our center were analyzed.Results ①Male more than female,medical tangles most happened the children under the age of 10 or the persons from 20 to 60 years old;② Most disputes happened in county-level health institutes.Surgical departments are the main areas of tangles;③In autopsy cases,clinical diagnosis of the cause of death are unknown in 41 cases.The consistency between clinical and pathological diagnoses was 74.8%.Forensic pathology identify the cause of death in 139 cases,and 13 cases can not find the cause of death.118 cases are pathological death,and most of them are happened in cardiovascular diseases,death of non-pathological are 21 cases;④136 hospital exist medical negligence in the process,and most of them happened in county-level health institutes.Technical negligence is the largest one,followed by the negligence liability.Conclusion Autopsy has great value of identification of the medical tangles.The hospital has to increase awareness of autopsy when it strengthen self-construction.

关 键 词：医疗纠纷 尸检 医疗过失 法医病理 

分 类 号：D919[医药卫生—法医学]