肺动脉血栓栓塞猝死的法医尸检及病理学探讨

Forensic Autopsy and Pathology Discussions of Sudden Death of Pulmonary Thromboembolism

目的:研讨肺动脉血栓栓塞猝死的法医尸检及病理学特点。方法:选取2012年1月至2016年6月经法医尸检证实的50例肺动脉血栓栓塞猝死患者为对象,对患者的临床资料、法医尸检病理学资料进行回顾性分析,再对其猝死的诱发原因、栓子来源等进行研析。结果:法医尸检报告显示,50例患者中,有2例患者的猝死诱发原因不明确,其余48例患者均存在诱发因素,包括21例创伤性骨折、20例外科手术、5例心肺病变、2例恶性肿瘤;50岁以上患者最多,占比88%;反复性栓塞共34例,占比68%;31例患者的栓子来源于下肢深静脉,19例患者的栓子来源于右心室;栓塞部位主要为左肺动脉及其分支、肺动脉主干及其左右分支。结论:肺动脉血栓栓塞猝死的法医尸检及病理分析报告明确了肺动脉血栓栓塞猝死的诱发原因及其栓子来源,可为减少肺动脉血栓栓塞猝死、刑侦、司法鉴定提供重要依据。

Objective： To study and discuss the forensic autopsy and pathological characteristics of pulmonary thromboembolism sudden death. Methods： select 50 cases of sudden death patients with pulmonary thromboembolism confirmed by forensic autopsy from January 2012 to June 2016 as the research object, retrospectively analyze the clinical information and forensic autopsy pathological data, analyze its causes and source of emboli. Results： The forensic autopsy report showed, among 50 cases, 2 cases of sudden death cause was not clear, the remaining 48 patients had predisposing factors, including 21 cases of traumatic fracture, 20 cases of surgical operation, 5 cases of pulmonary heart disease, 2 cases of malignant tumor; patients over 50 years account for 88%; a total of 34 cases were recurrent embolism, accounting for 68%; the emboli source of 31 cases was deep vein of lower limb, the embolism source of 19 cases was ventriculus dexter; the main site of embolism location was the left pulmonary artery and its branches, the main pulmonary artery and left and fight branches. Conclusion： forensic autopsy and pathological analysis of pulmonary thromboembolism sudden death can make clear the induced causes and embolus sources of pulmonary thromboembolism sudden death , so as to reduce pulmonary thromboembolism sudden death and provide important basis for criminal investigation and forensic judicial authentication.