贵州医科大学学报

2005, (01) 44-46

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86例医疗事故争议的法医病理尸检分析
An Analysis on 86 Cases of Forensic Autopsy Involved in Medical Disputes

王磊,王杰,黄映康,汪元河
WANG Lei, WANG Jie, HUANG Ying-kang, WANG Yuan-he (Department of Forensic Medicine, Guiyang Medical College, Guiyang 550004, China)

摘要(Abstract):

目的:探讨医疗事故争议的法医病理学鉴定特点。方法:对我室1999年1月~2004年6月尸检档 案中涉及医疗事故争议案例86例进行分类统计,并对法医病理学鉴定结果进行比较。结果:(1)争议尸检案例 从1999年1月~2001年12月的26例(8.5%)上升到2002年1月~2004年6月的60例(27.3%);(2)男女性 别差异无显著性;年龄分布在10岁以下的21例中,6例为出生1月以内的新生儿,11例为1~5岁的幼儿,高峰 分别出现在20~29岁和小于10岁,均为21例(24.4%),其次为30~39岁17例(19.8%);(3)争议多发生在县 (区)级以下的医院(包括个体诊所),共67例(77.9%),最常涉及外科、产科和急诊、门诊;(4)死亡原因最常见 心血管系统疾病21例(24.4%),呼吸系统疾病19例(22.1%),产科疾病15例(17.3%),机械性损伤11例 (12.8%);(5)临床诊断与法医病理诊断不相符23例(26.7%),无临床诊断30例(34.9%),主要集中在个体诊 所和乡镇卫生院。结论:法医病理学鉴定对处理医疗事故争议诉讼案件起积极作用。
Objective: To explore the characteristics of forensic pathological expertise in medical negligence disputes. Methods: 86 case files of forensic autopsy involved in medical negligence disputes were selected between January 1999 to June 2004. Statistical analysis was made on the basis of classification, and the results of pathological expertise were compared. Results: 1) The medical negligence dispute involved in forensic autopsy rose from 26 cases (8.5%) during 1999,1~2001,12 to 60 cases (27.3%) during 2002,1~2004,6.2) No significant difference was found between male and female. Among the 21 cases under age 10, 6 were neonatal less than 30 days old, 11 were 1~5 years old. The peaks appeared separately in ages of 20~29 and <10, and both were 21 cases in number. 3) Most disputes (67 cases, 77.9%) happened in medical institutes under county (district) level, including private clinics, and most commonly related to surgery, obstetrics, emergency, and out-patient departments. 4) The common causes of death were cardio-vascular (21 cases, 24.4%), pulmonary (19 cases, 22.1%), and obstetric (15 cases, 17.3%) diseases and mechanical injury (11 cases, 12.8%). 5) The clinical diagnosis of 23 cases (26.7%) did not agree with forensic autopsy pathological diagnosis, and 30 cases (34.9%) had no record of clinical diagnosis, mainly from private clinics and township-level health institutes. Conclusion: Forensic pathological expertise plays an active role in handling lawsuits involved medical negligence dispute.

关键词(KeyWords): 医疗事故;尸体解剖;法医学;病理状态,解剖学;医疗事故争议
malpractice; autopsy; forensic medicine; pathological conditions,anatomical; medical negligence dispute

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王磊,王杰,黄映康,汪元河
WANG Lei, WANG Jie, HUANG Ying-kang, WANG Yuan-he (Department of Forensic Medicine, Guiyang Medical College, Guiyang 550004, China)

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DOI: 10.19367/j.cnki.1000-2707.2005.01.013

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