羊水栓塞死亡医疗纠纷案件的法医学分析

发布时间：2018-02-23 02:53

本文关键词： 羊水栓塞死亡医疗纠纷法医学鉴定　出处：《中国司法鉴定》2009年04期 　论文类型：期刊论文

【摘要】：目的分析引发医疗纠纷的羊水栓塞死亡病例的相关因素,以帮助提高对羊水栓塞诊治能力,减少医疗纠纷。方法对我中心2006～2009年间鉴定的8例医疗纠纷相关羊水栓塞死亡病例的临床资料及过失认定进行回顾性分析。结果(1)医疗因素分析:7例具有使用催产素史;3例发生于产前破膜后,5例发生于产后;具有典型临床症状5例,不典型临床症状3例;早期诊断7例;3例实施子宫次全切除术;发生在二级医院以下6例。(2)法医学鉴定分析:催产素使用不当及观察记录缺陷占87.5%(7/8);7例早期诊断羊水栓塞,但在供氧、解痉和子宫切除方面存在治疗缺陷。结论提高对产前、产后羊水栓塞症状特点的认识和处置能力,强化病历记录规范、完整及充分告知说明,是减少医疗纠纷案件的关键,也是法医学鉴定判断的重要依据。
[Abstract]:Objective to analyze the factors related to the death of amniotic fluid embolism caused by medical disputes in order to improve the ability of diagnosis and treatment of amniotic fluid embolism. Methods the clinical data and fault determination of 8 death cases of amniotic fluid embolism associated with amniotic fluid embolism in our center from 2006 to 2009 were analyzed retrospectively. 3 cases occurred after prepartum rupture and 5 cases occurred postpartum. There were 5 cases with typical clinical symptoms, 3 cases with atypical clinical symptoms, 7 cases with early diagnosis and 3 cases with subtotal hysterectomy. Analysis of forensic identification in 6 cases under the second class hospital: the misuse of oxytocin and the defect of observation record accounted for 87.5% of the 7 cases of early diagnosis of amniotic fluid embolism, but there were some treatment defects in oxygen supply, spasmolysis and hysterectomy. Conclusion the diagnosis of amniotic fluid embolism in antepartum is improved. The recognition and management of the symptoms of postpartum amniotic fluid embolism, the strengthening of the standard of medical records, the complete and sufficient information and explanation are the key to reduce the medical dispute cases and the important basis for forensic identification and judgment.
【作者单位】：北京法源司法科学证据鉴定中心;
【分类号】：D919.4

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