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重庆医科大学基础医学院法医教研室
纸质出版日期:2010,
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[1]宋安林,刘云志,唐任宽,黄伟,杨明,朱素敏,朱英,赵鹏,李剑波.120例围生期妇女、婴儿死亡导致医疗纠纷案例分析报告[J].重庆医科大学学报,2010,35(05):744-749.
SONG An-lin, et al. A retrospective analysis of 120 case of women and infants died in perinatal which caused medical malpractice[J]. Journal of Chongqing Medical University, 2010,35(5):744-749.
[1]宋安林,刘云志,唐任宽,黄伟,杨明,朱素敏,朱英,赵鹏,李剑波.120例围生期妇女、婴儿死亡导致医疗纠纷案例分析报告[J].重庆医科大学学报,2010,35(05):744-749. DOI: 10.13406/j.cnki.cyxb.2010.05.004.
SONG An-lin, et al. A retrospective analysis of 120 case of women and infants died in perinatal which caused medical malpractice[J]. Journal of Chongqing Medical University, 2010,35(5):744-749. DOI: 10.13406/j.cnki.cyxb.2010.05.004.
目的:比较分析各相关因素对围生期妇女、婴儿死亡的影响
对引起死亡及导致医疗纠纷的原因进行总结。方法:回顾分析重庆医科大学法医教研室2000~2009年解剖医疗纠纷案例中围生期死亡妇女、婴儿共120例
其中妇女72例
婴儿48例。统计内容包括:尸检数量、死亡原因、死亡时间、医院级别、分娩方式、产前疾病、临床诊断与尸检诊断符合情况等。结果:①围生期妇女、婴儿死亡导致医疗纠纷主要集中在一级医院和二级医院;②各级医院围生儿组的平均误诊率为77.1%
远高于妇女组的误诊率:40.3%;③发生医疗纠纷的围生期死亡妇女年龄偏高
平均年龄30.5岁
大于28岁的占65.3%;④发生医疗纠纷的围生期死亡妇女职业主要为农民和无业
分别占62%和17%;⑤75%的死亡妇女为高危妊娠
其高危因素的前3位依次是:妊娠合并症、妊娠异常和分娩异常;⑥发生医疗纠纷的围生期妇女死亡原因前5位依次是:产后大出血、羊水栓塞、严重感染、肺动静脉血栓形成、急性坏死性胰腺炎
死亡时间的3个高峰期为:进入产程~分娩结束、分娩结束~产后6h、产后12h~产后24h;⑦发生医疗纠纷的围生期婴儿死亡原因前4位依次为:肺部因素、脐带因素、胎盘因素和产程因素
其中进入产程~出生48h是婴儿死亡的高峰期
占婴儿总死亡例数的77.1%。结论:医疗条件、高危妊娠、治疗抢救是否及时有效是影响围生期妇女、婴儿死亡的重要因素。提高一级医院和二级医院的医疗条件
增强其处理围生期妇女高危妊娠、产后大出血、羊水栓塞、围生儿肺部因素和脐带因素的能力
是降低重庆地区围生期妇女、婴儿死亡率及其导致的医疗纠纷发生率的关键。
Objective:To compare and analyze the relevant factors on perinatal women and infants mortality which caused medical malpractice
impact on the cause of death were reviewed.Methods:A retrospective analysis on the cause of death about women and infants died in perinatal for medical malpractice.Material came from department of Forensic Medicine
Chongqing Medical University
2000~2009;a total of 120 cases
of which 72 cases of women
48 cases of infants.Statistics include:number of autopsy
cause of death
time of death
hospital situation
mode of delivery
prenatal diseases
clinical diagnosis and autopsy diagnosis in line and so on.Results:①Women and infantsdied in perinatalwhich caused medicalmalpracticemosthappened in firstdegreeand second degreehospitals;② All levels of hospitals’average rate of misdiagnosis about perinatal child was 77.1%
far higher than the women’s team:40.3%;③Women died in perinatal which caused medical malpractice have a high average age:30.5 years old
and 65.3% of them were more than 28 years old;④Women died in perinatal which caused medical malpractice most were farmers and unemployed people
accounting for 62% and 17%;⑤75% of the women died in perinatal were in high-risk pregnancy
and the first three risk factors were pregnancy complications
pregnancy and childbirth abnormalities;⑥The first five factors leading women died in perinatal which caused medical malpractice were:postpartum hemorrhage
amniotic fluid embolism
severe infections
pulmonary artery and vein thrombosis
acute necrotizing pancreatitis;⑦The first four factors leading infant died in perinatal which caused medical malpractice were:lung factors
umbilical cord factors
placental factors and labor factors.The time from the birth process begin to 48 hours after birth is the peak of infant mortality
accounting for 77.1% of infant died in perinatal.Conclusion:Medical conditions
high-risk pregnancy and rescue are important factors for perinatal women and infant mortality.To improve medical conditions of first degree and second degree hospitals
and to enhance its ability of handling high-risk factors
postpartum hemorrhage
amniotic fluid embolism
and lung factors and umbilical cord factors of infant in perinatal is the key of reducing perinatal women and infants mortality;and also can reduce the incidence of medical malpractice in Chongqing area.
尸体解剖死亡原因病理诊断围生期医疗纠纷
autopsyCause of deathPathological diagnosisPerinatalMedical malpractice
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