新生儿脑损害相关产科医疗纠纷分析

Analysis of Obstetrical Disputes Related to Neonatal Brain Damage

目的分析新生儿脑损害相关的产科医疗纠纷,为改善产科医疗工作提供参考。方法收集28例涉新生儿脑损害的产科医疗纠纷案例,分析相关因素及责任原因。结果 28例中,19例最终鉴定为医疗事故,并以二级、三级事故及次要和轻微责任为主;无严重医疗事故发生;纠纷及责任等级较集中于一级、二级医院;分娩方式选择不当、新生儿护理处置及病历记录缺陷是主要责任原因;部分病例产科诊疗行为无不当,需考虑遗传代谢性疾病所致脑损害。结论严格遵守诊疗指南,合理分析处理及记录异常病征,是减少医疗责任事故的重要方法;对可疑遗传性疾病病例,注意留取标本备进一步分析。

Objective To analyze the obstetrical medical disputes related to neonatal brain damage, and providing reference for improving the obstetrical medical work. Methods 28 cases of obstetrical medical disputes involving neonatal brain damage were collected, analyze the related factors and the responsibility reasons. Results Among 28 cases, 19 cases were finally identified as medical accidents, with secondary and tertiary accidents and minor responsibilities as the main ones;no serious medical accidents occurred;disputes and responsibility levels were concentrated in primary and secondary hospitals;improper choice of delivery mode, nursing treatment of newborns and deficiency of medical records were the main causes of responsibility;some cases had improper obstetric diagnosis and treatment behavior, and genetic metabolism should be considered. Brain damage caused by disease. Conclusion Strict adherence to the guidelines for diagnosis and treatment, reasonable analysis and treatment of abnormal symptoms, is an important way to reduce medical liability accidents;for suspicious cases of hereditary diseases, attention should be paid to retaining specimens for further analysis.