肠道病毒71型感染9例死亡病例尸检分析

Forensic Analysis of 9 Cases with Enterovirus 71 Infection

目的对云南省9例肠道病毒71型(Enterovirus 71,EV71)感染后死亡的病例进行尸体检验,探讨EV71死亡案例的法医学特点.方法对昆明医科大学司法鉴定中心2010年7月22日至2013年5月30日,9例EV71死亡案例尸检资料进行分析.结果 9例患者均有"发热、咳嗽、呕吐"等临床表现,9例患者均有医疗机构按"感冒"或"手足口病"治疗的过程,9例尸检病理诊断为病毒性脑干脑炎致中枢性呼吸循环功能衰竭死亡.结论 EV71感染所致手足口病的病情发展较快,常导致脑干脑炎,引起死亡,易引发医疗纠纷,死亡患者的死因与家属及院方考虑的死因出入较大,及早开展死因鉴定有利于解决纠纷.

Objective To investigate the forensic characteristics of death cases of EV71 through retrospective analysis of 9 death forensic cases of Enterovirus 71 （EV71） . Methods Nine cases of EV71 death cases were collected,and the population characteristics, histopathological change,toxicology,pathology and causes of death of these cases were discussed. Results All 9 patients had fever, cough, emesis, and were treated as influenza or hand-foot and mouth disease （HFMD） in local hospitals, the condition was still deteriorating and finally died. The 9 autopsy cases were diagnosed as brain stem encephalitis and death in forensic diagnose. Conclusion The HFMD disease caused by EV71 infection progresses rapidly often leads to medical disputes, the patient＇s family and hospital＇s opinions on the causes of death in patients are often different,identifying the cause of death is conducive to resolve the disputes.