23例致死性肺血栓栓塞症的法医学病理分析
[Forensic pathological analysis on 23 cases of fatal pulmonary thromboembolism].
作者信息
Gong Dao-yin, Wang Yao-bin, Zhang Cen-cen, Huang Fei-jun
机构信息
West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu 610041, China.
出版信息
Fa Yi Xue Za Zhi. 2010 Feb;26(1):33-6.
OBJECTIVE
To analyze the forensic pathological characteristics of sudden death caused by pulmonary thromboembolism and the chronological transformation of thrombus and explore the assessment method of the causal relationship between previous trauma and the following fatal PTE episode.
METHODS
All the 23 cases reviewed here were collected from our institute files from the year of 1998 to 2008.
RESULTS
Trauma, surgery and braking etc. were all risky factors of PTE. Of these cases, 12 cases were caused by trauma, 21 cases were caused by surgery and 22 cases died in hospitals which were often happened one or two weeks after injury or one week's postoperative time. Of all the cases, 6 cases had single attack of thrombus and the rest 17 cases had the recurrence of thrombus. The number of the leg deep vein to be the embolic source was 16 cases which were often seen in the left leg.
CONCLUSION
It is important to confirm the embolic source, trauma, surgery and chronological events in determing the sudden death with PTE.
目的
分析肺血栓栓塞症所致猝死的法医病理学特征及血栓的时间演变，探讨既往创伤与随后致命性肺血栓栓塞症发作之间因果关系的评估方法。
方法
本文回顾的23例病例均收集自我院1998年至2008年的档案。
结果
创伤、手术及制动等均为肺血栓栓塞症的危险因素。这些病例中，12例由创伤引起，21例由手术引起，22例死于医院，多在受伤后一两周或术后一周发生。所有病例中，6例为单发血栓，其余17例为血栓复发。栓子来源为下肢深静脉的有16例，多见于左侧下肢。
结论
在确定肺血栓栓塞症所致猝死时，确认栓子来源、创伤、手术及时间顺序事件很重要。
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