Byard Roger W
Forensic Science SA, 21 Divett Place, Adelaide, South Australia, Australia.
School of Medicine, The University of Adelaide, Level 3 Helen Mayo North, Frome Road, Adelaide, 5005, Australia.
Forensic Sci Med Pathol. 2019 Mar;15(1):122-124. doi: 10.1007/s12024-018-9991-9. Epub 2018 Jun 11.
Deep vein thrombosis resulting in lethal pulmonary thromboembolism is not-infrequently encountered in forensic cases. Predisposing factors include immobility, recent surgery, previous deep venous thromboses/pulmonary thromboembolism, indwelling central venous lines, major trauma, the oral contraceptive pill, pregnancy, congenital cardiac disease, sepsis, malignancy, systemic lupus erythematosus, renal failure and certain inherited thrombophilias. Venous thrombosis associated with air travel was reported in the early 1950's and called the "economy class syndrome", although it is now recognized that reduced movement on long distance flights is more significant than seating class. Long-distance flights of eight hours or more are associated with a two to fourfold increase in the risk of deep venous thrombosis, but only in those individuals who have underlying risk factors. With increasing numbers of flights of more than 16 h duration forensic pathologists are well placed to monitor the potential impact of extended flying on the incidence of lethal pulmonary thromboembolism.
在法医案件中，深静脉血栓形成导致致死性肺血栓栓塞并非罕见。诱发因素包括活动受限、近期手术、既往深静脉血栓形成/肺血栓栓塞、留置中心静脉导管、重大创伤、口服避孕药、妊娠、先天性心脏病、败血症、恶性肿瘤、系统性红斑狼疮、肾衰竭以及某些遗传性易栓症。20世纪50年代初报道了与航空旅行相关的静脉血栓形成，并称之为“经济舱综合征”，尽管现在人们认识到长途飞行中活动减少比座位等级更重要。八小时或更长时间的长途飞行会使深静脉血栓形成风险增加两到四倍，但仅在那些有潜在危险因素的个体中如此。随着持续时间超过16小时的航班数量增加，法医病理学家完全有条件监测长时间飞行对致死性肺血栓栓塞发生率的潜在影响。
