Mizukami H, Shimizu K, Shiono H, Uezono T, Sasaki M
Department of Legal Medicine, Asahikawa Medical College, Midorigaoka Higashi 2-1-1-1, Asahikawa 078-8510, Japan.
Leg Med (Tokyo). 1999 Dec;1(4):204-9. doi: 10.1016/s1344-6223(99)80039-x.
To clarify the forensic diagnosis of hypothermia, the postmortem changes in the bodies of 211 cases of hypothermia (partly including death from diseases) encountered between January 1990 and January 1999 were studied as follows:i) The rectal temperature had been measured in 83 cases in which the time after death was known relatively clearly, and the rate of decrease in the rectal temperature per hour was evaluated. The rate of decrease in the rectal temperature was 2.3 +/- 1.2 degrees C, 2.7 +/- 1.5 degrees C and 3.6 +/- 1.9 degrees C per hour (mean +/- SD) when the ambient temperature was > or = 0 degrees C, 0 degrees C > to >-10 degrees C and -10 degrees C > or =, respectively. ii) The color of blood collected from the right and left hearts was different in 43 (33.6%) of the 128 cases of death from cold that underwent inquest and in 20 (87.0%) of the 23 cases that underwent forensic autopsy. This color difference was useful for the diagnosis of fatal hypothermia. iii) Gastric or duodenal submucosal bleeding (Wishnewski's spots) was noted in 10 (43.5%) of the 23 cases that underwent forensic autopsy. iv) Paradoxical undressing was observed in 35 (21.3%) of the 164 cases that underwent inquest.
为明确低温的法医学诊断,对1990年1月至1999年1月间遇到的211例低温病例(部分包括因病死亡)尸体的死后变化进行了如下研究:i)在83例死亡时间相对明确的病例中测量了直肠温度,并评估了直肠温度每小时的下降速率。当环境温度分别≥0℃、0℃>至> -10℃和≤ -10℃时,直肠温度每小时的下降速率分别为2.3±1.2℃、2.7±1.5℃和3.6±1.9℃(均值±标准差)。ii)在接受死因调查的128例冻死病例中,有43例(33.6%)左右心采集的血液颜色不同;在接受法医尸检的23例病例中,有20例(87.0%)左右心采集的血液颜色不同。这种颜色差异有助于诊断致死性低温。iii)在接受法医尸检的23例病例中,有10例(43.5%)出现胃或十二指肠黏膜下出血(维什涅夫斯基斑)。iv)在接受死因调查的164例病例中,有35例(21.3%)观察到反常脱衣现象。