81例脂肪栓塞综合征致死法医学分析  

Forensic analysis of 81 cases of fatality of fat embolism syndrome

作　　者：李国良 邵玉铭 丁润涛 王旭 LI Guoliang;SHAO Yuming;DING Runtao;WANGXu(School of Forensic Medicine and Laboratory Medicine,Jining Medical University,Jining 272067,China)

机构地区：[1]济宁医学院法医学与医学检验学院,济宁272067

出　　处：《济宁医学院学报》2018年第5期352-354,共3页Journal of Jining Medical University

基　　金：济宁医学院青年教师科研扶持基金(JY2017FY011)

摘　　要：目的分析脂肪栓塞综合征(fat embolism syndrome,FES)的损伤原因、损伤类型、伤后死亡时间、脂肪栓子累及器官法医病理学特点,为此类案件的法医病理学鉴定提供参考。方法选取某司法鉴定中心2000年1月1日至2018年6月20日因FES死亡的81例,先常规HE染色观察血管内脂肪栓子成分,后采用冰冻切片苏丹Ⅲ染色法进行确证。结果伤后发生FES致死的时间以48h内为主,占84.0%(68/81)。损伤类型以单纯骨折及骨折合并软组织损伤为主。损伤原因以道路交通事故和殴打作用于机体为主,占84.0%(68/81)。肺组织每个视野(100倍)内脂肪栓子平均数量为4.33个。结论 FES致死鉴定应当明确伤后死亡时间、损伤原因和类型,并严格根据法医病理学诊断标准确定肺内脂肪栓子数量。Objective To analyze the causes, types of injury, and postmortem interval after injury, involvement of fat suppository and the characteristics of organ forensic pathology in fat embolism syndrome（ FES）, and to provide reference for forensic pathology identification of such cases. Methods 81 cases of FES death from January 1,2000 to June 20,2018 in a forensic center were selected. The components of fat suppository in blood vessels were observed with regular HE staining, and then confirmed with frozen slice Sudan III staining. Results The time for FES death after injury was mainly 48h, accounting for 84.0% （ 68/81 ）. The damage types were mainly simple fracture and fracture combined with soft tissue damage. The causes of damage were mainly caused by road traffic accidents and beatings ,accounting for 84.0% （ 66/81 ）. The average number of fat suppositories per field of vision（ 100 times） in lung tissue was 4.33. Conclusion FES should clearly identify the time of death, cause and type of injury after injury,and determine the number of adipose embolus in lung strictly according to the diagnostic criteria of forensic pathology.

关 键 词：法医学 脂肪栓塞 致死 脂肪栓子 

分 类 号：D919.1[医药卫生—法医学]