105例精神病人尸体检验的法医学分析

目的回顾分析精神病人尸体检验案例的死亡原因及死亡方式,为医疗卫生服务和司法鉴定提供参考。方法收集中国刑事警察学院物证鉴定中心2004—2019年受理并结案的精神病人尸体检验案例105例,分为疾病死亡、自杀死亡、意外死亡及他杀死亡4组,统计各组的常见死亡原因,分析各组之间年龄、病程、体重指数(body mass index,BMI)、性别的差异。结果105例中,男性60例、女性45例,精神病病程(12.9±10.4)年,死亡时年龄(51.3±11.4)岁,61.0%为精神分裂症。疾病死亡50例(47.6%),该组死者年龄最大、精神病病程最长、BMI最低,肺动脉血栓栓塞、呼吸系统感染、心脏性疾病是常见死亡原因。意外死亡26例(24.8%),交通事故是最常见死亡原因。他杀死亡15例(14.3%),全部为男性,颅脑损伤是最常见死亡原因。自杀死亡14例(13.3%),该组死者年龄最小,病程最短,高坠是最主要的自杀方式。结论了解精神病人的常见死亡原因有助于制定措施以降低该群体的死亡率。分析死亡方式时需要综合考虑死者的年龄、病程、性别等因素。

Forensic Analysis of 105 Autopsy Cases of Psychiatric Patients

Objective To provide reference for medical and health services and forensic expertise,the causes and manners of death of psychiatric patients were analyzed retrospectively.Methods A total of 105 autopsy cases of psychiatric patients accepted and settled by Institute of Forensic Science of Criminal Investigation Police University of China from 2004 to 2019 were collected.The cases were divided into four groups:disease death,suicidal death,accidental death and homicidal death.The common causes of death of each group were statistically analyzed and the differences in age,disease duration,body mass index(BMI)and gender among the groups were assessed.Results Of the 105 cases,60 were male and 45 were female,the course of psychosis was(12.9±10.4)years,the age of the deceased was(51.3±11.4)years,and 61.0% was schizophrenic.There were 50 cases(47.6%)in the disease death group,in which the psychiatric patients were the oldest and had the longest course of psychosis and lowest BMI.Pulmonary thromboembolism,respiratory infections,and cardiogenic disease were the most common causes of death in the group.There were 26 accidental deaths(24.8%),among which traffic accidents were the most common cause of death.There were 15 homicidal deaths(14.3%),all of which were male,with craniocerebral injury being the most common cause of death.There were 14 suicidal deaths(13.3%).In suicidal death group,the age of the deceased was the youngest,the course of psychosis was the shortest and falling from the height was the most common way to commit suicide.Conclusion Understanding the common causes of death of psychiatric patients may contribute to developing measures to reduce the mortality rate of the population.It is necessary to investigate the age,course of psychosis and gender of the deceased when assessing the manner of death.