Zhang Feng-qin
Fada Institute of Forensic Medicine and Science, China University of Political Science and Law, Beijing 100040, China.
Fa Yi Xue Za Zhi. 2007 Feb 15;23(1):46-8.
The purpose of this study was to use autopsy to explore cause of death and to identify medical errors after cardiac surgery.
Clinical and autopsy findings in 6 cases were analyzed with respect to the clinical diagnosis, operation types, death time and features, and autopsy findings, medico-legal disputes and related medical errors.
There were total 6 patients. The procedures involve cardiac valve replacement (4), coronary artery bypass (1), and congenital aortic transposition repair (1). Three patients had sudden death one week after surgery and 3 from congestive heart failure. The findings include myocardial infarction (2), massive myocardial injury (1), endocarditis (2), and multi-organ failure (1). The families in all six cases suspected malpractice. The major concerns were operation indication and timing, selection of operation equipment, operative mishandling, inadequate post-operative care and timely therapeutic invention, inadequate informed consent regarding the severity of the disease itself, the risks of heart surgery, and its prognosis after the procedures.
Autopsy can be used to determine the cause of death, to assess the quality of the operation and post operation management, and to help to resolve malpractice disputes
本研究旨在通过尸检探究心脏手术后的死因并识别医疗差错。
对6例患者的临床及尸检结果进行分析，内容包括临床诊断、手术类型、死亡时间及特征、尸检结果、医疗纠纷及相关医疗差错。
共有6例患者。手术包括心脏瓣膜置换术（4例）、冠状动脉搭桥术（1例）和先天性主动脉转位修复术（1例）。3例患者术后1周猝死，3例死于充血性心力衰竭。尸检结果包括心肌梗死（2例）、大面积心肌损伤（1例）、心内膜炎（2例）和多器官功能衰竭（1例）。所有6例患者的家属均怀疑存在医疗过失。主要关注点包括手术指征和时机、手术设备的选择、手术操作失误、术后护理及及时治疗干预不足、关于疾病本身严重程度、心脏手术风险及其术后预后的知情同意不充分。
尸检可用于确定死因、评估手术及术后管理质量，并有助于解决医疗纠纷。
