摘要
目的分析心脏手术相关医疗纠纷的临床及法医学特点,并就发生原因进行剖析及提出相应防范措施。方法对2002年1月-2011年12月四川华西法医学鉴定中心受理的四川省各级医疗机构发生的17例与心脏手术相关的医疗纠纷法医学鉴定资料进行回顾性分析。结果 17例心脏手术相关医疗纠纷中,12例进行了尸体解剖死因鉴定,死亡原因有心脏传导系统出血,术后感染,低心排量综合症、肺动脉高压、失血性休克致死等。其余5例加上尸体解剖2例在内共7例进行了医疗过错鉴定,存在的医疗过错包括术前检查不完善,告知不充分,手术操作不细致,术后观察、处理不足,医疗记录不完整等。结论心脏手术相关医疗纠纷与术后并发症关系密切,医护人员应重视对心脏术后并发症的防治。尸体解剖对解决心脏术后死亡引起的医疗纠纷具有重要意义。
Objective To analyze the clinical features, causes of medical disputes related with cardiac surgery, and provide preventive measures. Methods We retrospectively analyzed the data of 17 cases of cardiac surgery-related medical disputes collected from 2002 to 2011 in medico-legal expertise center of West China Hospital. Results Among the 17 cases of cardiac surgery-related medical disputes, autopsies were performed on 12 of the patients who died after the surgery to figure out the causes of their death. The causes included hemorrhage of cardiac conducting system, postoperative infection, low cardiac output syndrome, severe pulmonary hypertension, and hemorrhagic shock, etc. Seven cases including two of the autopsy ones and the other five eases were applied for medical fault identification. The medical malpractice included careless preoperative preparation, mistakes in surgery, and inadequate postoperative anticoagulant therapy after surgery, etc. Conclusions Cardiac surgery-related medical disputes are closely related with postoperative complications. The medical staff should attach importance to the circumvention and treatment for the complications. In order to solve these disputes rationally, autopsy should be performed on the patients who died after the surgery.
出处
《华西医学》
CAS
2013年第4期547-550,共4页
West China Medical Journal
关键词
心脏手术
医疗纠纷
死亡原因
法医学鉴定
Cardiac surgery
Medical disputes
Cause of death
Forensic identification
