Püschel K, Schulz F, Darrmann I, Tsokos M
Institute of Legal Medicine, University of Hamburg, Germany.
Int J Legal Med. 1999;112(2):101-6. doi: 10.1007/s004140050210.
In a prospective autopsy series of 39 cases of fatal drowning, the detailed dissection of the skeletal muscles of the neck, anterior/posterior trunk and the upper extremities in layers revealed intramuscular hemorrhages of different size and shape in 20 cases (51.3%). Light microscopy examination showed a premortal (vital/agonal) type of muscular alteration in 7 (50%) out of 14 macroscopical hemorrhage-positive cases. These hemorrhages and histological muscle alterations are attributed to agonal convulsions, hypercontraction and overexertion of the affected muscle groups. As long as no cutaneous or subcutaneous hematomas above the hemorrhages can be found, these autopsy findings (with special reference to histology) can serve as an additional criterion concerning the differentiation of drowning and another cause of death.
在一项对39例致命溺水病例的前瞻性尸检系列研究中，对颈部、躯干前/后及上肢的骨骼肌进行分层详细解剖，发现20例（51.3%）存在不同大小和形状的肌内出血。光学显微镜检查显示，在14例宏观出血阳性病例中的7例（50%）存在濒死期（生命期/濒死期）类型的肌肉改变。这些出血和组织学上的肌肉改变归因于濒死期惊厥、受影响肌肉群的过度收缩和过度用力。只要在出血上方未发现皮肤或皮下血肿，这些尸检结果（特别是组织学结果）可作为区分溺水和其他死因的附加标准。
