尸表检验用于交通事故死因鉴定的可靠性研究

Study on the reliability of postmortem external examination for determining the cause of death in traffic accidents

目的探究尸表检验用于交通事故死因鉴定的可靠性。方法回顾性研究20例交通事故相关死亡案例,对比尸表检验死因鉴定意见与最终死因鉴定意见的异同,并对尸表检验在交通事故死因鉴定中的准确率,主要对误、漏诊类型及其占比进行统计分析。结果基于单一尸表检验出具的死因鉴定意见中,与最终死因鉴定意见相吻合的仅占35%,而存在不同程度误、漏诊的高达45%(Ia类严重误诊占5%,Ib类严重漏诊占5%,Ⅱb类部分漏诊占35%),另外20%无法明确死因。结论孤立的尸表检验在交通事故死因鉴定中的可靠性较低,建议将尸体断层影像学技术作为常规检查,并联合应用尸体解剖以提升法医学鉴定的质量。

Objective To study the reliability of postmortem external examination for determining the cause of death in traffic accidents.Methods 20 traffic accident-related death cases that met the criteria were retrospectively studied.The similarities and differences between the postmortem external examination and the final determination results were compared.Statistical analysis was performed on the accuracy,main types of errors,and their proportions of postmortem external examination in determining the cause of death of traffic accidents.Results Only 35%of the conclusion on causeof-death issued by the postmortem external examination were consistent with the final determination,while 45%had variable degrees of misdiagnosis and missed diagnosis(including 5%type Ia major misdiagnosis,5%type Ib major missed diagnosis,and 35%type IIb partially missed diagnosis).Moreover,the remaining 20%were unable to determine the cause of death.Conclusion The reliability of postmortem external examination for determining the cause of death in traffic accidents is relatively low.It is suggested that postmortem cross-sectional imaging should be used as a routine method,and autopsy should be combined to improve the accuracyofforensic medicine examination.