主动脉夹层破裂致死的医疗纠纷回顾性分析

Retrospective Analysis of Medical Disputes Caused by Death from Aortic Dissection

目的探讨主动脉夹层破裂死亡引起的医疗纠纷特点、解决方法及鉴定注意事项。方法对114例主动脉夹层致死的法医学司法鉴定案例进行回顾性分析。结果主动脉夹层破裂患者多发年龄段为30~50岁;以消化道症状为表现的64例;表现为胸背部疼痛的21例;24 h内死亡83例;误诊率为86.8%。误诊为消化道疾病、泌尿系疾病、心肌梗死的分别占总误诊案例的64.4%、15%、10%。结论主动脉夹层医疗纠纷的发生存在多方因素,医疗纠纷鉴定过程中应综合考虑疾病的发展过程及医疗的不可预知性。

Objective To discuss the traits of medical disputes caused by death from aortic dissection,and to explore the solutions and identification notes.Methods The 114 forensic judicial identification cases of death from aortic dissection were retrospectively analyzed.Results Most patients with aortic dissection were between 30 and 50 years old;64 cases had gastrointestinal symptoms,and 21 cases had aches in chest and back.There were 83 cases of death within 24 h.The misdiagnosis rate was 86.8%.The cases misdiagnosed as gastrointestinal disease,urinary system disease,or myocardial infarction,accounted for 64.4%、15%、10%of total misdiagnosed cases,respectively.Conclusion Many factors are related to the occurrence of medical disputes of aortic dissection,therefore,the development process of disease and the unpredictability of medical treatment must be comprehensively taken into consideration.