肺血液坠积现象判断溺死的辅助作用  

Assisting Role of Pulmonary Hypostasis Phenomenon in Diagnosis of Drowning

作　　者：巫坚 黎增强 代文道 赵建[3] 周亚萍[4] 权国林 赵乾皓[1] 马雁兵[3] 成建定[1] WU Jian;LI Zeng-qiang;DAI Wen-dao;ZHAO Jian;ZHOU Ya-ping;QUAN Guo-lin;ZHAO Qian hao;MA Yan-bing;CHENG Jian-ding(Guangdong Province Translational Forensic Medicine Engineering Technology Research Center,Faculty of Forensic Medicine,Zhongshan School of Medicine,Sun Yat-Sen University,Guangzhou 510000,China;Liwan District Branch of Guangzhou Public Security Bureau,Guangzhou 510140,China;Guangzhou Forensic Science Institute&Key Laboratory of Forensic Pathology,Ministry of Public Security,Guang-zhou 510442,China;Marine Branch of Guangzhou Public Security Bureau,Guangzhou 510235,China;Haizhu District Branch of Guangzhou Public Security Bureau,Guangzhou 510220,China)

机构地区：[1]中山大学中山医学院法医学系广东省法医学转化医学工程技术研究中心,广东广州510000 [2]广州市公安局荔湾区分局,广东广州510140 [3]广州市刑事科学技术研究所法医病理学公安部重点实验室,广东广州510442 [4]广州市公安局水上分局,广东广州510235 [5]广州市公安局海珠区分局,广东广州510220

出　　处：《法医学杂志》2022年第1期71-76,共6页Journal of Forensic Medicine

基　　金：国家自然科学基金资助项目(81901919,81920108021);广东省自然科学基金资助项目(2020A1515010078);广州市科技计划资助项目(2019030001,2019030002,2019030012);公安部科技强警基础工作专项资助项目(2020GABJC38)。

摘　　要：目的研究溺死和非溺死尸体中肺血液坠积现象,评估该现象在辅助溺死法医病理学死因判断中的价值。方法收集广州市2011年1月—2021年6月以来经系统尸体检验明确死因的案件235例,按照尸体发现位置分为水中尸体组(97例)和非水中尸体组(138例),水中尸体组又分为水中溺死组(90例)和水中非溺死组(7例),非水中尸体组分为非水中溺死组(1例)、非水中非溺死组(137例),经3名资深法医病理学家独立对案件尸体解剖照片进行阅片,判断肺组织是否出现血液坠积,统计肺血液坠积现象的检出率。结果水中溺死组(90例)肺血液坠积现象检出率为0,阴性率为100%;水中非溺死组(7例)肺血液坠积现象检出率为100%,阴性率为0,两组检出率差异有统计学意义(P<0.05);水中尸体组肺血液坠积现象检出率为7.22%,非水中尸体组(剔除2例后剩余136例)肺血液坠积现象检出率为87.50%,差异有统计学意义(P<0.05)。结论肺血液坠积现象阴性是溺死的特征性尸体征象,可辅助溺死的法医病理学诊断。Objective To study the phenomenon of pulmonary hypostasis in corpses of various causes of death,and to explore the potential value of this phenomenon in assisting forensic pathological diag‐nosis of drowning.Methods A total of 235 cases with clear cause of death through systematic autopsy were collected from January 2011 to June 2021 in Guangzhou.According to the location of body dis‐covery,the cases were divided into the water body group(97 cases)and the non-water body group(138 cases),and the water body group was further divided into the water drowning group(90 cases)and the water non-drowning group(7 cases).Non-water body group was further divided into the non-water drowning group(1 case)and the non-water non-drowning group(137 cases).Three senior foren‐sic pathologists independently reviewed autopsy photos to determine whether there was hypostasis in the lungs.The detection rate of pulmonary hypostasis was calculated.Results The detection rate of pul‐monary hypostasis in the water drowning group(90 cases)was 0,and the negative rate was 100%.The detection rate of pulmonary hypostasis in the water non-drowning group(7 cases)was 100%and the negative rate was 0.The detection rate of pulmonary hypostasis in the water body group and in the non-water body group(after excluding 2 cases,136 cases were calculated)was 7.22%and 87.50%,respectively.There were statistically significant differences in the detection rate of pulmonary hypostasis between water body group and non-water body group,and between water drowning group and water non-drowning group(P<0.05).Conclusion The disappearance of pulmonary hypostasis can be used as a specific cadaveric sign to assist in the forensic pathological diagnosis of drowning.

关 键 词：法医病理学 溺死 死后入水 肺血液坠积 尸体征象 

分 类 号：DF795.1[医药卫生—法医学]