2例汽车腹部安全带综合征致死的案例分析

Analysis of Two Cases of Death Caused by Abdominal Seat Belt Syndrome

目的报道并分析2例汽车腹部安全带综合征致小肠—肠系膜破裂大出血死亡的道路交通事故的成伤机制、死因,以及汽车腹部安全带的作用,为道路交通事故的法医学鉴定、伤者的救治和预防及汽车安全带的设计提供建议。方法收集本教研室鉴定的2例道路交通事故致死案例,基于《国际疾病分类》(international classification of diseases,ICD)死因分析观点,综合分析损伤、疾病和饮酒等多因素共同作用致死的法医学事实因果关系及其原因力,从损伤后果探讨减少伤害的预防措施。结果提示汽车腹部安全带对于腹部及腹腔内脏软组织的保护作用存在一定的缺陷,易造成腹腔大出血死亡。结论对于道路交通伤害,除了重点关注重要器官致命伤及其致伤物和成伤机制之外,还需注意腹部小肠—肠系膜是否破裂出血,防止延误救治,及早预防,提高治愈率。同时建议汽车制造商进一步改进安全带等司乘人员保护设施的设计,提升汽车腹部安全带的保护作用。

Objective To report 1)injury mechanisms and causes of death in 2 cases of road traffic accidents dueto intestinal and mesenteric rupture and massive hemorrhage(abdominal seat belt syndrome),and 2)role of abdominal seat belt usage;and to provide suggestions for 1)forensic medical identification of road traffic accidents,treatment and prevention of the injured and 2)design of automobile seat belt.Methods Two road traffic accidental death cases were identified by our Medicolegal Department.Based on the death-cause analysis viewpoint of international classification of diseases(ICD),forensic causality and its causal force of death caused by multiple factors such as injury,disease and alcohol consumption were comprehensively analyzed,and prevention of injury reduction was discussed from the injury consequences.Results The data indicated that there were defects in protective effects of abdominal safety belts on the soft tissues of abdominal and abdominal viscera,which easily caused the death via abdominal hemorrhage.Conclusions For fatal traffic injuries,in addition to focusing on injuries to important organs and their mechanisms of injuries,it is also necessary to pay attention to whether the abdominal small intestines and mesenteries are ruptured and bleeding,so as to prevent delay in treatment,prevention and recovery.At the same time,automobile manufacturers should further enhance protection for drivers and passengers,such as designs for safety belts and protection function of abdominal safety belts.