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硬脑膜下血肿在法医学中的重要性:一项符合STROBE标准的回顾性研究。

Importance of effusion of blood under the dura mater in forensic medicine: A STROBE - compliant retrospective study.

作者信息

Chmieliauskas Sigitas, Anuzyte Joginte Saule, Liucvaikyte Julita, Laima Sigitas, Jurolaic Eleonora, Rocka Saulius, Fomin Dmitrij, Stasiuniene Jurgita, Jasulaitis Algimantas

机构信息

Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences of the Faculty of Medicine of Vilnius University.

State Forensic Medicine Service.

出版信息

Medicine (Baltimore). 2018 Sep;97(39):e12567. doi: 10.1097/MD.0000000000012567.

Abstract

Subdural hemorrhage is commonly associated with mechanical brain injury and has a correspondingly high mortality rate. Subdural hematomas may immediately provoke symptoms or may be initially asymptomatic, with further symptoms evolving rapidly and fatally.The data regarding forensic autopsy of victims were obtained from The State Forensic Medicine Service of Lithuania between the years 2013 and 2016. A retrospective study was performed including 110 patients, whose cause of death was subdural hemorrhage. 95% confidence intervals were calculated.It was calculated, that in cases of sudden death, after subdural hemorrhage was diagnosed, a higher concentration of ethyl alcohol in blood (mean 2.22 ± 1.3%) demanded a smaller amount of blood under the dura matter (mean 81.6 ± 60.5 g) in order for the patient to die. It was also noted that hospitalized patients with subdural hemorrhage had a smaller concentration of blood ethyl alcohol (mean 1.33 ± 1%) and a larger amount of blood under the dura (mean 135.6 ± 82.9 g).Due to the toxic effect of ethyl alcohol, even a small amount (81.6 ± 60.5 g) of blood under the dura matter can determine a sudden death.

摘要

硬膜下出血通常与机械性脑损伤相关,死亡率相应较高。硬膜下血肿可能立即引发症状,也可能最初无症状,随后症状迅速发展并导致死亡。关于受害者法医尸检的数据来自立陶宛国家法医学服务中心2013年至2016年期间的记录。进行了一项回顾性研究,纳入110例死因是硬膜下出血的患者,并计算了95%置信区间。结果发现,在猝死病例中,诊断出硬膜下出血后,血液中乙醇浓度较高(平均2.22±1.3%)时,为使患者死亡,硬膜下所需血量较少(平均81.6±60.5克)。还注意到,住院的硬膜下出血患者血液中乙醇浓度较低(平均1.33±1%),硬膜下血量较多(平均135.6±82.9克)。由于乙醇的毒性作用,即使硬膜下少量(81.6±60.5克)血液也可导致猝死。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7edd/6181611/05be731eb4c4/medi-97-e12567-g001.jpg

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