过敏性反应死亡法医病理学研究.doc.docVIP

? 过敏性反应死亡法医病理学研究 ?? 【摘要】目的探讨过敏性反应死亡的法医病理学特点，从而解决困扰法医学工作者对过敏性反应死后诊断的鉴定要点。方法对华西法医鉴定中心1995-2004年尸检检出的26例药物过敏性死亡案例进行回顾性分析。结果本组26例药物过敏所致死亡案例的死者年龄以31—40岁的例数最多，占了38％；26例因药物过敏所致死亡的案例中，12例为青霉素类药物过敏，为引起过敏最常见的药物；而药物使用途径引起过敏反应死亡的案例中以注射为主，共20例；以个体诊所及基层医院多发生过敏反应死亡的案例；18例在使用药物后出现典型的严重的过敏性反应的临床表现；15例为在用药后半小时内发生死亡；病理解剖可见咽喉粘膜水肿20例，其中咽喉腔阻塞大于75％2例，50?75％5例，25—50％7例，小于25％6例，显微镜下检查嗜酸性粒细胞浸润咽喉粘膜者21例、肺组织18例；6例血清ige检测值呈现出显著的升高。结论过敏性反应的死后诊断应结合死者的生前临床病史，死亡时间，生前临床表现，病理解剖发现及血清lge检测值综合分析。【关键词】过敏性反应；法医病理学【中图分类号】d919．1f文献标识码】a【文章编号】1007—9297(2005)04—0297—04the?forensic?pathological?study?on?death?of?anaphylaxis．lln?xia?yi?x?，chen?xiao-gang，xie?ying?guo?shao_j；eng．the?school?ofbasical?and?forensic?medicine?ofsichuan?university?chengdu?610041【abstract】objective?to?study?the?characteristics?of?anaphylaxis?in?forensic?pathology，to?clarify?the?puzzling?critic?pointsof?the?postmortem?diagnosis．methods?data?was?collected?from?26?autopsy?cases?of?anaphylaxis?in?forensic?medical?identificationcenter?of?west?china?sichuan?between?1995?and?2004．?results?38％?of?the?cases?were?between?3?1?and?40?years?old．?the?mostcommon?reason?resulting?in?anaphylaxis?was?penicillin，which?cause?the?anaphylaxis?often?by?injection(20?cases)．the?alergic?casesusually?happen?at?the?private?clinics?and?the?base?hospitals．?18?cases?have?the?characteristic?symptoms；?15?cases?died?in?30?min·utes?after?the?use?of?certain?drugs．?th?e?edema?of?throat?of?20?cases?was?found?in?autopsy，?thereinto，?the?block?of?throat?were?over75％?in?2?cases．between?50％?and?75％?in?5?cases，between?25％?and?50％?in?7?cases，less?than?25％?in?6?cases．under?the?microscopy，the?eosinophil?were?observed?in?the?mucous?membrane?of?throat?of?2?1?cases?and?in?the?lung?of?1?8cases．?th?e?serum?igeincreases?notably?in?6?cases．?conclusion?th?e?postmortem?diagnosis?of?anaphylaxis?should?synchronously?consider?clinical?history，time?after?death，symptoms?before?death，observations?in?the?autopsy?and?the?serum?ige．?[NextPage]?【key?words】anaphylaxis；forensic?