605例不同年份的中毒尸检资料对比分析研究

发布时间：2018-03-29 00:25

本文选题：中毒　切入点：尸检资料　出处：《华中科技大学》2009年硕士论文

【摘要】：【研究背景】中毒死亡为与机械性损伤、机械性窒息、猝死及其他原因(如电击、高低温损伤等)同等重要的死亡原因。法医毒理病理学研究的重点和难点,包括对常见毒物性状、种类、中毒原因、毒理作用、中毒量和致死量、中毒血浓度和致死血浓度、中毒所致病变、毒物化验检材采取、保存、送检、中毒或中毒死亡方式的法医学鉴定等方面的研究。大多数的文献资料仅对个别的中毒死亡案例进行报道分析,或者是对单一毒物的深入研究,缺乏对中毒死亡案例的横向对比研究,和对中毒的宏观把握、发展趋势预测及相关因素对中毒致死案例影响的分析。近年来,许多学者通过案例收集、分类汇总并作横向对比,对中毒死亡这一类案例进行研究,为中毒案件的死因鉴定、侦查破案提供了重要的依据。随着我国科学技术的发展,特别是农药制作技术、中医药检测技术的发展、催眠镇静安定类药物及毒品滥用的增加等,中毒案件出现了一些新的变化和发展。本课题收集本单位实际工作中的案例,对各类中毒案例的数量变化趋势、中毒死亡者的年龄分布及中毒途径等方面进行对比研究,为中毒案例的实际鉴定工作提供理论依据,并为中毒事件的预防工作作出贡献。【目的】本课题选用作者单位1957年～2008年实际检案中的中毒案例605例,通过统计学方法对收集资料进行对比研究,分析不同年份中毒案例所占比例的变化情况,中毒死亡者年龄分布情况,毒物种类在不同年份的变化发展情况,并对这些变化规律进行原因分析,为法医学鉴定提供理论依据。【材料与方法】对华中科技大学同济医学院法医学系法医病理教研室1999年1月~2008年12月(以下简称C组)检验的、且均经系统尸检和病理组织学检查的各种中毒案例216例,除作一般统计学分析外,着重对毒物种类特点、中毒途径、中毒方式等问题进行分析探讨,并与本单位1983年~1998年(以下简称B组)的158例中毒资料,及1957年~1982年(以下简称A组)的231例中毒资料进行比较。【结果】①C组与A、B组相比,中毒案例的相对数量呈减少趋势;②中毒死亡者以男性居多,且以青壮年为主;③毒物种类上传统农药中毒案例呈递减趋势,而新型农药显著增加;④两种或两种以上药(毒)物中毒的数量显著增加,进行毒化分析时应重点注意,尤其是单一成份中毒达不到致死浓度时,应考虑两种及两种以上成份中毒时的毒物协同作用的可能;⑤中毒途径上,口服中毒案例减少,呼吸道中毒案例显著增加;⑥中毒在各类法医检案中仍占一定比例,因此不同年代和不同地区的中毒死亡案例的统计分析信息对于实践具有一定指导意义。【结论】本文案例资料显示,中毒案例数量较以往有明显增长趋势,中毒死者年龄分布、毒物种类等方面均较以往有明显变化,尤其多种毒物联合应用所致中毒案件显著增多。
[Abstract]:Background: poisoning death is an important cause of death as much as mechanical injury, mechanical asphyxia, sudden death and other causes (such as electric shock, high and low temperature injury, etc.). Including toxic properties, types, causes of poisoning, toxicological effects, toxic and lethal amounts, toxic blood concentrations and lethal blood concentrations, pathological changes caused by poisoning, toxicological tests, taking, preservation, and submission for inspection, The majority of the literature reports and analyses only individual cases of poisoning deaths, or the in-depth study of a single poison. There is a lack of horizontal comparative study of poisoning death cases, macroscopic grasp of poisoning, prediction of development trend and analysis of the influence of related factors on poisoning death cases. In recent years, many scholars have studied the death of poisoning cases through case collection, classification and horizontal comparison, and identified the cause of death of poisoning cases. With the development of science and technology in China, especially the development of pesticide production technology, the development of traditional Chinese medicine detection technology, the increase of hypnotic sedative and tranquilizing drugs and drug abuse, etc. There have been some new changes and developments in poisoning cases. This subject collects cases from the actual work of our unit, and makes a comparative study on the changing trend of the number of poisoning cases, the age distribution of poisoning deaths and the ways of poisoning, etc. To provide theoretical basis for the practical identification of poisoning cases, and to contribute to the prevention of poisoning incidents. [objective] to select 605 poisoning cases from 1957 to 2008, and to analyze the changes of the proportion of poisoning cases in different years by means of statistical method. The age distribution of poisoning victims, the changes and development of poison types in different years, and the causes of these changes were analyzed to provide a theoretical basis for forensic identification. [materials and methods] 216 cases of poisoning were examined in the Forensic Pathology Department of Tongji Medical College, Tongji Medical College, Huazhong University of Science and Technology from January 1999 to December 2008 (Group C), and were all examined by systematic autopsy and histopathological examination. In addition to general statistical analysis, the characteristics of toxicants, ways of poisoning, ways of poisoning and so on were analyzed and discussed. The data of 158 cases of poisoning from 1983 to 1998 (group B for short) in our unit were analyzed and discussed. And 231 cases of poisoning from 1957 to 1982 (group A) were compared. [results] 1Compared with group A B, the relative number of poisoning cases in group C showed a decreasing trend. However, the number of poisoning caused by two or more drugs (poisons) was significantly increased by the new pesticide, so we should pay more attention to the poisoning analysis, especially when the single component poisoning is not up to the lethal concentration. It is necessary to consider the possible toxic ways of synergism of two or more components. There are fewer cases of oral poisoning and a significant increase in cases of respiratory tract poisoning, which still account for a certain proportion of all kinds of forensic medical examination cases. Therefore, the statistical analysis information of poisoning death cases in different years and different regions has certain guiding significance for practice. [conclusion] the case data of this paper show that the number of poisoning cases is obviously increasing, the age distribution of poisoning victims and the types of poisons are obviously changed, especially the cases of poisoning caused by the combined use of many kinds of poisons are obviously increased.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：D919.2

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