致死性心脏压塞38例法医病理学分析

Forensic pathological analysis on 38 cases of fatal cardiac tamponade

目的探讨致死性心脏压塞的法医病理学特点和鉴定要点。方法对成都中医药大学附属医院病理科2005~2015年完成的38例心脏压塞致死案例进行回顾分析。结果致死性心脏压塞好发于男性(71.1%),平均年龄44岁;直接死因血性积液34例,非血性4例;根本死因以疾病多见(73.7%),主要为夹层动脉瘤、冠心病、恶性肿瘤;发病12小时内死亡占75%;涉及医疗行为30例(78.9%),26例无医疗过错(86.7%);疾病致死案件涉及伤病关系15例(39.5%)。结论掌握致死性心脏压塞的法医病理学特点和鉴定路径是准确完成该类案件法医学鉴定的基本要求。

Objective To explore the forensic pathological characteristics and the main identification points of fatal cardiac tamponade. Methods 38 cases of fatal cardiac tamponade from department of pathology, the first affiliated hospital of chengdu university of TCM from 2005 to 2015 were reviewed and analyzed retrospectively. Results Fatal cardiac tamponade mostly occurred to men（71.1%） with an average age of 44; Bloody effusion accounted for 85% of the direct causes of death（34 cases）. The most underlying causes of death were diseases（73.7%）, majorly aortic dissection, coronary heart disease and malignant tumors. Seventy five percent of death occurred within 12 hours of illness. Medical behaviors were involved in 30 cases（78.9%）, of which 26 cases（86.7%）were without medical malpractice. The relationship between injury and disease was involved in 15 fatal cases（39.5%）. Conclusion The basic requirement for accurately completing forensic medical appraisal of fatal cardiac tamponade cases was to master the forensic pathological characteristics and the path of forensic identification.