哽死的法医病理学鉴定一例  

A Case of Forensic Pathology Identification of Choking

作　　者：吕成 裴锐锐 吴朝俊 LÜCheng;PEI Ruirui;WU Chaojun(Guizhou Tongjian Judicial Expertise,Zunyi 563000,Guizhou,China)

机构地区：[1]贵州通鉴司法鉴定所,贵州遵义563000

出　　处：《刑事技术》2024年第3期327-330,共4页Forensic Science and Technology

摘　　要：哽死是由于异物从内部阻塞呼吸道,阻碍气体交换所引起的窒息性死亡。在法医病理学司法鉴定中,哽死较少见,其鉴定依据主要是尸体检验时在死者的咽喉、气管、支气管等部位发现异物,这些异物可以是食品类,也可以是非食品类。本文案例中的异物为糍粑,主要呈干硬团状,气道内异物总量多,完全阻塞了左右主支气管,导致窒息死亡。此前曾有误吞气球造成哽死的案例报道,与本案例的相似之处在于异物都可能具有单向活瓣作用,不同之处在于异物梗阻气道的部位不相同。哽死必须经过系统尸体解剖,排除其他死因,并结合案情等进行综合分析判断,才能诊断死因。绝大多数哽死都是意外致死。本文梳理了哽死的病理特征以及与其他死因的鉴别要点,希望能为法医同行提供有价值的参考依据。Choking is asphyxial death caused by a foreign body blocking the respiratory tract from the inside and obstructing the exchange of gas.In forensic pathology identification,choking is rare,and its identification is mainly based on the discovery of foreign bodies in the throat,trachea,bronchus and other parts of the deceased during autopsy,which can be food,such as lumps,or non-food.There have been previous reports of cases of choking caused by mistakenly swallowing balloons.The similarity with this case is that foreign bodies may have one-way valve effect,but the difference is that the parts of the foreign bodies obstructing the airway are different.The foreign body in this case was dried glutinous rice cake,which was mainly dry and hard,and the total amount of foreign bodies in the airway was large,which completely blocked the left and right main bronchus and caused the asphyxial death.The identification opinion of choking death must go through a systematic autopsy,exclude other causes of death,and make a comprehensive analysis and judgment in combination with the case,so as to diagnose the cause of death.The vast majority of choking deaths are accidental.This paper systematically summarized a case of accidental choking,sorted out the pathological features and points of identification with other causes of death,hoping to provide valuable reference for forensic colleagues.

关 键 词：法医病理学 机械性窒息 哽死 气道阻塞 

分 类 号：D919[医药卫生—法医学]