7例广泛性软组织挫伤后死亡机制分析

Death mechanism analysis in 7 cases after extensive soft tissue injury

目的探讨无重大疾病、无重要脏器损伤和未检出中毒的尸体,因广泛性软组织损伤而致死的机制。方法对收集和整理因体表广泛软组织损伤而死亡的尸体检验所有资料进行综合分析,研究其共性所在。结果软组织损伤均有一定的广度,损伤面积达体表面积的29％-43％;软组织损伤均有一定的深度,损伤达皮肤、皮下及肌肉组织;死亡时间在伤后4h至6 d之间;致伤物均为钝性物,且反复打击; 尸检未发现重大疾病及中毒。结论广泛软组织挫伤导致微循环障碍是死亡的根本原因,创伤性挤压综合症、创伤后呼吸窘迫综合症、创伤性休克、多脏器功能衰竭也是直接致死的原因。

Objective To investigate death mechanism in 7 cases after extensive soft tissue injury. Methods All materials of soft tissue injuries from autopsy were collected, and their features as well as common natures were comprehensively analyzed. Results Soft tissue injuries generally had certain ranges, and injured surface area accounted for 29% to 43% percent of body surface area. Soft tissue injuries had certain depth and reached to skin, subcutaneous tissue and muscular tissue. The time of death was 4 h to 6 d after injury. All the stroke tools were blunt and stroked repeatedly. Severe diseases and poisonings were not found by autopsy. Conclusion The basic cause of death was microcirculation malfunction caused by extensive soft tissue contusion. Besides, traumatic crush syndrome, post traumatic respiratory syndrome, traumatic stroke and MODS were also the direct causes of death.