冠状动脉支架植入术中死亡法医病理检验4例  

Forensic pathology examination of death during intracoronary stenting:a report of four cases

作　　者：毋静婷 穆佳琦 代号 陈晓刚[1] Wu Jingting;Mu Jiaqi;Dai Hao;Chen Xiaogang(West China School of Basic Medical Sciences&Forensic Medicine,Sichuan University,Chengdu,Sichuan,610041)

机构地区：[1]四川大学华西基础医学与法医学院,四川成都610041

出　　处：《中国法医学杂志》2024年第2期153-156,共4页Chinese Journal of Forensic Medicine

摘　　要：目的总结冠状动脉支架(coronary stent,CS)植入术中死亡者法医病理检验的要点。方法回顾了4例CS植入术中死亡者法医病理尸检资料。结果急性心肌梗死紧急行冠状动脉左旋支CS植入术1例,择期手术3例。发现冠状动脉夹层2例、血管破裂1例。冠状动脉破裂患者同时发现支架内急性血栓形成。三例患者5处新近安置CS部位血管狭窄程度较生前造影报告轻。未安置CS的血管生前造影检查报告的病变部位狭窄程度较死后病理检验重。结论死后病理检验可有效检出冠状动脉损伤、支架血栓形成,但需解决冠状动脉腔内支架原始形态观察的难题。Objective To summarize the experience of forensic pathology examination of patients died during coronary stent(CS)implantation.Methods The records of 4 autopsies were reviewed to make a report.Results The CS implantation was performed emergently to treat acute myocardial infarction in 1 case.The other three CS implantations were scheduled.The coronary artery dissection was recorded in both clinical records and autopsy reports of 2 patients.The coronary artery rupture was recorded in the clinical and autopsy records of 1 patient.Acute CS thrombosis was also found in this patient during autopsy.In 3 patients,the degrees of vascular stenosis at the 5 sites of CS implantation in the autopsy reports were less than those in the ante-mortem angiography records.For the vascular stenosis observed in coronary artery without CS implantation,the degrees of vascular stenosis reported in the ante-mortem angiography record were greater than those in the post-mortem gross examination records.Conclusion Post-mortem pathological examination can effectively detect coronary artery injury and CS thrombosis.It is necessary to solve the problem of observing the structure and appearance of expanded CS intactly.

关 键 词：法医病理学 冠状动脉支架植入术 手术中死亡 冠状动脉病理检验 

分 类 号：D919.4[医药卫生—法医学]