肺动脉血栓栓塞猝死的法医尸检及病理分析  

Forensic Autopsy and Pathological Analysis of Sudden Death from Pulmonary Thromboembolism

作　　者：熊枫[1] 邬震宇 XIONG Feng;WU Zhenyu(Furong Judicial Identification Center,Hunan Second People's Hospital,Changsha,Hunan Province,410007 China;Qingyang Community Health Service Center,Kunshan City,Suzhou,Jiangsu Province,215300 China)

机构地区：[1]湖南省第二人民医院芙蓉司法鉴定中心,湖南长沙410007 [2]江苏省苏州市昆山市青阳社区卫生服务中心,江苏苏州215300

出　　处：《系统医学》2022年第10期39-41,45,共4页Systems Medicine

摘　　要：目的 研究分析肺动脉血栓栓塞猝死的法医尸检及病理情况。方法 对2019年1月—2021年8月该地区刑事技术部门提供的肺动脉血栓栓塞猝死的30例死亡患者的尸检及病理报告进行回顾性分析,总结死亡患者年龄分布、死前症状、血栓部位与血栓来源、高危因素等情况。结果 30例死亡患者中,20~39岁者3例,占比10.00%;40~59岁者7例,占比23.33%;60~79岁者9例,占比30.00%;80~89岁者11例,占比36.67%。患者死前症状主要为呼吸困难、胸闷、晕厥,例数分别为12例(40.00%)、8例(26.67%)、6例(20.00%)。血栓部位主要为左右肺动脉,血栓主要源自左侧下肢深静脉,例数分别为16例(53.33%)、17例(56.67%)。肺动脉血栓栓塞猝死的高危因素为固定体位、创伤或手术、冠状动脉粥样硬化。结论 在法医尸检中,确定肺动脉血栓部位、血栓来源、分析高危因素是分析肺动脉血栓栓塞猝死病理的着重点。Objective To study and analyze the forensic autopsy and pathological conditions of sudden death from pulmonary thromboembolism.MethodsFrom January 2019 to August 2021,the autopsy and pathological reports of30 patients who died of sudden death from pulmonary artery thromboembolism provided by the criminal technology department in the region were retrospectively analyzed.The age distribution,pre-mortem symptoms,thrombus location and source of thrombus,and high-risk factors of the dead patients were summarized.ResultsAmong the 30 dead patients,3 were aged 20-39,accounting for 10.00%.There were 7 cases aged 40 to 59,accounting for 23.33%.There were 9 cases aged 60 to 79,accounting for 30.00%.There were 11 cases aged 80-89,accounting for 36.67%.The main symptoms before death were dyspnea,chest tightness,and syncope,with 12 cases(40.00%),8 cases(26.67%),and 6 cases(20.00%),respectively.The thrombus was mainly located in the left and right pulmonary arteries,and the thrombus mainly originated from the left lower extremity deep vein,with 16 cases(53.33%) and 17 cases(56.67%),respectively.The high risk factors of sudden death from pulmonary thromboembolism were fixed position,trauma or surgery,and coronary atherosclerosis.ConclusionIn forensic autopsy,determining the location of pulmonary artery thrombus,the source of thrombus,and analyzing high-risk factors are the key points in analyzing the pathology of sudden death from pulmonary artery thromboembolism.

关 键 词：肺动脉血栓栓塞 猝死 法医尸检 病理 

分 类 号：R543[医药卫生—心血管疾病]