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目的从法医病理学角度分析引起医疗纠纷的孕产妇死亡原因、医疗纠纷发生原因并提出相关防范措施。方法对1999年1月-2008年12月间46例引起医疗纠纷的孕产妇死亡案例进行回顾性分析。结果孕产妇死亡年龄以30岁以上多见,死亡时妊娠时间以围产期居多(87.0%)。死亡原因中产科失血性休克死亡21例(45.7%),栓塞类疾病死亡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例中属非医疗过失性医疗纠纷8例(17.4%),医疗过失性纠纷38例(82.6%),医疗过失的原因主要为抢救不及时、处理不当、误诊误治等。涉及纠纷的医院以县区级医院居多(54.3%)。结论通过法医病理学司法鉴定查明死亡原因,明确医疗责任及医疗纠纷原因,已成为解决孕产妇死亡医疗纠纷的重要手段。
Objective To analyze the causes of maternal death caused by medical disputes and the causes of medical disputes from the perspective of forensic pathology and propose relevant preventive measures. Methods A retrospective analysis of 46 maternal death cases that caused medical disputes between January 1999 and December 2008 was conducted. Results Maternal death was more common in patients over 30 years of age, with the majority of perinatal pregnancy deaths (87.0%). Among the deaths, 21 (45.7%) died of obstetric hemorrhagic shock, 8 (17.4%) died of embolic diseases, 5 (10.8%) died of infectious diseases and 12 (26.1%) died of other causes. Among 46 cases, 8 cases (17.4%) were non-medical negligent medical disputes and 38 cases (82.6%) were medical negligent disputes. The main causes of medical negligence were not timely rescue, improper treatment and misdiagnosis. The number of hospitals involved in disputes is mostly county-level hospitals (54.3%). Conclusion Forensic pathology forensic identification to identify the cause of death, a clear medical liability and the reasons for medical disputes, has become an important means of resolving medical disputes on maternal death.