目的 分析主動脈夾層的臨床及病理特點。 方法 回顧性分析1998年1月－2011年10月26例主動脈夾層致死的臨床及法醫尸檢病理資料，對其發病、死亡經過、診斷、死因進行總結。 結果 26例主動脈夾層平均發病年齡為39.2歲，男女比例為3.3︰1；26例中6例無臨床診斷，17例誤診，3例疑似診斷。26例主動脈夾層中，夾層破裂致心包填塞死亡20例，夾層破裂致失血性休克死亡5例，主動脈夾層未破裂1例系心衰致死；26例按DeBakey分類標準9例為Ⅰ型，14例為Ⅱ型，3例為Ⅲ型。 結論 臨床應警惕主動脈夾層的特殊臨床表現并采取必要的輔助檢查，有助于主動脈夾層的診治和減少醫療糾紛的發生。
【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.