医疗纠纷中135例猝死分析

目的为探讨引起医疗纠纷案例中猝死发生的特点，特别是其年龄、性别、科室、疾病的分布和发生纠纷的原因，为有关单位调处医疗纠纷和制定有关法规提供科学依据。方法自本教研室1955～1996年42a间受理的法医病理学尸检资料中挑选各种医疗纠纷案例；制定统一表格，将其中猝死者逐一登记，并进行统计分析。结果42a中涉及医疗纠纷的淬死135例。其中男87例、女48例。年龄自新生儿～67岁。以新生儿和婴儿居多（67例），男明显多于女；其次为25～34岁的青壮年组（21例），女多于男。近12a发生的猝死（94例）是过去30a（41例）的2．3倍。猝死疾病以呼吸系统最常见（46％），次为心血管系统疾病（25％）；但54例成人猝死者心血管系统疾病占首位（26例），次为泌尿生殖系统疾病（12例）。发生的科室多见于产科和儿科（74例）。结论认为近10年来医疗纠纷中猝死案例明显增多；医疗纠纷中非医疗事故远多于医疗事故；法医病理尸检对正确、合理地调处医疗纠纷，并对探讨猝死的发生机制，反馈、丰富和发展相关临床学科的内容，以及提高诊治水平均具有重要意义。

Medical tangle and sudden unexpected death with report of 135 autopsy cases

Objective To explore the character of sudded unexpected death (SD) in medical tangle such as age, sex, clinical department of occurrence, kinds of disease etc. Methods By retrospective investigation, all cases associated with medical tangle were collected from the files of legal autopsy in our department between 1955~1996. The data of each SD case were filled in united from, and all data were statistically analyzed. Results Thetotal number of SD cases obtained were 135, composed of 87 male and 48 female. The age in these cases ranged from newborn to the aged. The SD cases were firstly found in newborn and infants group (67 cases), and secondly in manhood group (25~34 year, 21 cases ). These was a significant predominance of male in newborn and infants group, whereas female in manhood group. In recent ten year, SD cases were mostly respiratory diseases (46%) and cardiovascular diseases (25% ) in 54 cases of adults, however, most of them were cardiovascular diseases (26 cases ) and urogenital diseases (12 cases). Clinical department of occurrence were often seen in obstetirc and podiatric departments (total 74 cases). Conclusion The results indicate that SD cases in medical tangle increased obviously in recent ten years, nonmedical negligence .were significantly out numbered by medical negligence. Forensic pathological autopsy have importantly significance in evaluating cause of SD cases associated with medical tangle.