【摘要】 目的 從法醫病理學角度分析引起醫療糾紛的孕產婦死亡原因、醫療糾紛發生原因并提出相關防范措施。 方法 對1999年1月-2008年12月間46例引起醫療糾紛的孕產婦死亡案例進行回顧性分析。 結果 孕產婦死亡年齡以30歲以上多見，死亡時妊娠時間以圍產期居多（87.0%）。死亡原因中產科失血性休克死亡21例（45.7%），栓塞類疾病死亡8例（17.4%），感染性疾病死亡5例（10.8%），其他原因死亡12例（26.1%）。46例中屬非醫療過失性醫療糾紛8例（17.4%），醫療過失性糾紛38例（82.6%），醫療過失的原因主要為搶救不及時、處理不當、誤診誤治等。涉及糾紛的醫院以縣區級醫院居多（54.3%）。 結論 通過法醫病理學司法鑒定查明死亡原因，明確醫療責任及醫療糾紛原因，已成為解決孕產婦死亡醫療糾紛的重要手段。
【Abstract】 Objective To analyze the causes of maternal death with medical disputes, the causes of medical disputes, and to recommend the related preventions through a forensic pathological angle. Methods We retrospectively analyzed 46 cases of maternal death with medical disputes which were collected by West China Center of Forensic Medicine Service in Sichuan between January 1999 and December 2008. Results Most maternal deaths occurred over 30 years old. They most frequently happened during the peri-natal period (87.0%). The causes of death included obstetric hemorrhagic shock in 21 cases (45.7%), embolism-like diseases in 8 cases (17.4%), infectious diseases in 5 cases (10.8%) and other reasons in 12 cases (26.1%). Among all the 46 cases of medical disputes, 8 (17.4%) were not due to medical malpractices, while the other 38 cases (82.6%) had something to do with such medical malpractices as delayed or inappropriate treatment, misdiagnosis and so on. Most of the malpractices in these cases involved medical institutions at a county level (54.3%). Conclusion Forensic judicatory appraisal is important to resolve medical disputes of maternal death by finding out the cause of death, clarifying the medical responsibility and clearing the cause of medical disputes.
Citation： ZHANG Changquan,WU Chao,LIU Xiaofei,XIAO Xiao,LIU Yuan,GUAN Peng. Forensic Pathological Analysis of Maternal Death with Medical Disputes. West China Medical Journal, 2011, 26(3): 427-430. doi: Copy
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