20例脂肪栓塞死亡的法医学分析  

Forensic Analysis of Death Caused by Fat Embolism: A Study of 20 Autopsy Cases

作　　者：周兰[1,2] 穆娇[1] 董红梅[1] 张吉[1] 

机构地区：[1]华中科技大学同济医学院法医系,湖北武汉430030 [2]江苏省公安厅物证鉴定中心,江苏南京210024

出　　处：《法医学杂志》2013年第6期431-433,共3页Journal of Forensic Medicine

摘　　要：目的分析脂肪栓塞综合征(fat embolism syndrome,FES)死亡的一般情况以及法医病理学特点,为此类案件的法医病理学鉴定提供参考。方法选取某大学法医学鉴定中心1999—2012年20例FES死亡案件,对其一般情况及法医病理学特点(包括致伤方式、损伤类型、临床表现、病理学改变等方面)进行总结。结果脂肪栓塞主要见于损伤导致的长骨骨折和全身大面积软组织损伤,主要类型为肺脂肪栓塞,偶见合并脑脂肪栓塞,症状多出现在伤后和术后较短时间内,组织病理学检查可在肺小血管内检见大量脂滴并经特殊染色证实。结论 FES死亡案例在损伤类型、脂肪栓塞出现症状时间及组织病理学表现等方面均有一定规律和特点,在鉴定中应注意进行特殊染色(油红O染色)处理,寻找FES的直接证据。Objective To analyze the general and forensic pathological characteristics of death due to fat embolism syndrome （FES） and to provide reference data for forensic identification. Methods Twenty au- topsy cases due to FES were selected from the forensic center of a medical college from 1999 to 2012. The general and forensic pathological characteristics such as the ways and types of injuries, clinical mani- festation and the pathological changes were summarized. Results Fat embolism mainly occurred after long bone fracture or a large area of soft tissue injury with the majority of cases being fat embolism of lung and occasional cases being combined embolisms of lung and brain as well. The onset of symptoms appeared shortly after the injury or surgery. Lipid droplets could be observed within small pulmonary vessels and verified by special staining. Conclusion There are particular characteristics in death due to FES in concern with types of injuries, onset of symptoms and pathological findings. In order to find out the direct evidence of FES, special staining （oil red O staining） can be used in the forensic identification.

关 键 词：法医病理学 栓塞 脂肪 骨折 

分 类 号：R683[医药卫生—骨科学]