640例死因中救治伤和濒死期损伤的回顾性分析  

A Retrospective Study of Rescue Injuries and Agonal Injuries in 640 Death Cases

作　　者：李暄仪 吕国丽 杨文[4] 吴春雷 刘小山 罗斌[1] 廖信彪[2,5] 黄二文 LI Xuanyi;LV Guoli;YANG Wen;WU Chunlei;LIU Xiaoshan;LUO Bin;LIAO Xinbiao;HUANG Erwen(Department of Forensic Medicine,Sun Yat-sen School of Medicine,Sun Yat-sen University,Guangzhou 510080,China;Key Laboratory of Forensic Pathology,Ministry of Public Security,Guangzhou 510050,China;Guangzhou Institute of Criminal Science and Technology,Guangzhou 510030,China;Criminal Police Brigade,Tianhe Branch of Guangzhou Public Security Bureau,Guangzhou 510635,China;Criminal Technology Center,Guangdong Provincial Public Security Department,Guangzhou 510050,China)

机构地区：[1]中山大学中山医学院法医学系,广东广州510080 [2]法医病理学公安部重点实验室,广东广州510050 [3]广州市刑事科学技术研究所,广东广州510030 [4]广州市公安局天河区分局刑事警察大队,广东广州510635 [5]广东省公安厅刑事技术中心,广东广州510050

出　　处：《中山大学学报(医学科学版)》2025年第1期81-87,共7页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家重点研发计划课题(2023YFC3303902)。

摘　　要：【目的】为明确识别救治伤和濒死期损伤的区别,避免重复鉴定、错鉴。【方法】本研究基于中山大学法医鉴定中心和广州市公安局天河区分局2013—2022年5923例死因鉴定案例,回顾性研究死因鉴定所见的救治伤和濒死期损伤的特征及其对死因鉴定产生的影响。【结果】在全部5923例案例中,检见救治伤或濒死期损伤的案例640例,624例接受救治其中609例检见救治伤(97.60%),44例检见濒死伤,13例两类损伤均检见。640例案例中男性441例,女性199例,死亡年龄从0至95岁不连续分布;死因以疾病占比最高,其次为机械性损伤和窒息。救治伤主要表现为肋、胸骨骨折和胸前区或面部软组织损伤,亦可见心包破裂等。濒死期损伤以意识丧失后摔跌伤、呼吸道异物吸入或多次暴力损伤多见。640例案例中19例发生重复鉴定,其中15例检见救治伤,6例检见濒死期损伤,2例两类损伤均检见。与未检见两类损伤的案例相比,救治伤和濒死期损伤均显著提高了重复鉴定率(χ^(2)=4.04,P=0.044;χ^(2)=43.49,P<0.001)。640例案例中11例(1.72%)在初次鉴定中两类损伤被错鉴为初始损伤,13例两类损伤参与造成死亡。【结论】通过揭示两类损伤的流行病学特征,用数据证明了两类损伤与更高的重复鉴定和错鉴率有关,为减少重复鉴定和错鉴,提高死因鉴定的准确性提供了参考依据。【Objective】To clearly identify the difference between rescue injuries and agonal injuries and to avoid duplicate identifications and misidentifications.【Methods】Based on the forensic pathological data of 5923 cases of death cause identification from 2013 to 2022 in Sun Yat-sen University Forensic Identification Center and Guangzhou Tianhe District Branch of Guangzhou Public Security Bureau,this study retrospectively studied the characteristics of rescue injuries and agonal injuries seen in cause of death identification and their influence on cause of death identification.【Results】Among all the 5923 cases,640 cases were found to have rescue injuries or agonal injuries,and 624 cases received treatment,of which 609 cases were found to have rescue injuries(97.60%),44 cases were found to have agonal injuries,and 13 cases were found to have both types of injuries.Among the 640 cases,441 were male and 199 were female.The age of death was discontinuously distributed from 0 to 95 years old.The leading cause of death was disease,followed by mechanical injury and asphyxia.The main manifestations of rescue injuries were rib and sternum fractures,soft tissue injuries in the prechest area or face,and pericardial rupture.The most common injuries in agonal stage were falling after unconsciousness,inhalation of foreign body in respiratory tract or multiple violent injuries.Among the 640 cases,19 cases were repeatedly identified,including 15 cases of rescue injuries,6 cases of agonal injuries,and 2 cases of both types of injuries.Compared with the cases where neither type of injuries was detected,the repeated identification rate of treatment injuries and agonal injuries was significantly increased(χ^(2)=4.04,P=0.044;χ^(2)=43.49,P<0.001).Among the 640 cases,11 cases(1.72%)were misidentified as the initial injuries in the first identification,and 13 cases had combined rescue injuries or agonal injuries that were involved in death.【Conclusions】By elucidating the epidemiological characteristics of the two types of in

关 键 词：死因鉴定 救治伤 濒死期损伤 重复鉴定 法医病理学 

分 类 号：D919.1[医药卫生—法医学]