21例主动脉夹层死亡引发纠纷案例分析  

Analysis of 21 Autopsy Cases of Aortic Dissection with Disputes

作　　者：杨嵩民[1,2] 张广政[1] 

机构地区：[1]郑州大学基础医学院法医学教研室,河南郑州450052 [2]登封市公安局刑侦支队,河南郑州452470

出　　处：《法医学杂志》2012年第6期432-434,共3页Journal of Forensic Medicine

摘　　要：目的探讨对引发纠纷的涉及主动脉夹层死亡病例进行法医学鉴定的程序和方法。方法收集某机构2006—2011年涉及主动脉夹层死亡法医学鉴定案件21例,分析此类案件的发生原因、特点。结果21例中引发纠纷的原因多为临床误诊或生前遭受轻微暴力;在各例的病理分型中De BakeyⅠ型和Ⅱ型(或Stanford A型)居多;在此类案件的鉴定中,寻找夹层的内膜和外膜破裂口、观察血管壁分层形态十分重要。结论经验不足、观察不严密和就诊过程仓促是漏诊主动脉夹层的主要原因,对损伤和疾病关系以及原发病和并发症之间关系的把握是本类鉴定的难点。Objective To explore procedures and methods of forensic＇, investigation for the death cases of aortic dissection with disputes. Methods Twenty-one death cases of aortic dissection with disputes fi＇om 2006 to 2011 were collected. All the data were analyzed to investigate the reasons and features of the disputes. Results The main causes of the disputes were clinical misdiagnosis or slight ibrce. The pathologic type of De Bakey （ I and II） or Stanford A were common in each case. For the cases dying of aortic dissection, it was significantly important to detect the rupture of entry and exit and observe the dissection of arterial wall. Conclusion The main causes of clinical misdiagnosis are insufficient experiences, careless observation and curtness in medical treatment. The difficuh points in these cases are confirmation of the relationships between injury and disease, the primary affection and complication.

关 键 词：法医病理学 主动脉夹层 纠纷 

分 类 号：R543.1[医药卫生—心血管疾病]