分析医疗纠纷法医尸检与临床病理间的关系

Analysis of the Relationship between the Death of Forensic Autopsy and Clinical Pathology in Medical Disputes

目的通过探究法医尸检与临床病理之间的关系,为医患双方提供更权威的依据,从而有效减少医疗纠纷的发生。方法回顾性分析2017~2018年我市司法鉴定中心104例医疗纠纷案中的已逝患者临床资料,从而评估法医尸检在医疗纠纷事件中的意义。结果回顾资料显示,医疗纠纷案已逝患者中,临床诊断明确死亡原因的94例,即有8例患者死因不明,而法医尸检查明死因98例,未查明确定死因患者6例,并且通过法医尸检确定死于以心脑血管疾病为首的病理性疾病患者96例,死于非病理性疾病患者8例。回顾性资料显示,医疗纠纷高发的科室主要是外科,而医疗纠纷高发的医院则主要集中在二级医院,医疗过失比重较其他医院高。结论法医尸检能有效查明患者死亡原因,为医疗纠纷案的判定提供有效价值,也说明在今后的临床死亡案例中应充分依靠有效的法医尸检,医患双方应重视尸检的科学性,以尸检结果来判定,以此更好减少医疗纠纷案的发生。

Objective To explore the relationship between forensic autopsy and clinical pathology, to provide a more authoritative basis for both doctors and patients, thus effectively reducing the occurrence of medical disputes.Methods The clinical data of deceased patients in 104 medical dispute cases of the city’s judicial appraisal center from 2017 to 2018 were retrospectively analyzed to evaluate the significance of forensic autopsy in medical disputes.Results The retrospective data showed that among the patients who had died in the medical dispute case, 94 cases were diagnosed with a clear cause of death, that is, 8 patients had unknown causes of death, while forensic autopsy confirmed 98 cases of death and 6 cases of patients with confirmed cause of death were not identified. And through forensic autopsy, 96 patients died of pathological diseases including cardio-cerebral vascular disease, and 8 patients died of non-pathological diseases. According to the retrospective data, the departments with high medical disputes are mainly concentrated in the surgical department, while the hospitals with high medical disputes are mainly concentrated in the secondary hospitals. The proportion of medical negligence is higher than other hospitals.Conclusion Forensic autopsy can effectively identify the cause of death and provide effective value for the judgment of medical disputes. It also indicates that in the future clinical death cases, effective forensic autopsy should be fully relied on. Both doctors and patients should pay attention to the scientific nature of autopsy. The autopsy results were not determined, so as to better reduce the incidence of medical disputes.