Forensic pathological analysis of 12 cases of sudden death caused by pulmonary thromboembolism
肺动脉血栓栓塞猝死12例法医病理分析

摘要

目的 分析肺动脉血栓栓塞猝死的法医病理特点。方法 将2023年8月-2024年8月经法医尸检证实的12例肺动脉血栓栓塞猝死患者作为研究对象，对所有患者的临床资料、法医尸检报告、病理性资料等进行回顾性分析，并对其猝死的诱发原因、栓子来源进行研究分析。结果 相关法医尸检报告显示，12例肺动脉血栓栓塞猝死患者中，1例患者猝死诱发原因不明确，其余11例均明确相关诱发原因；50岁以上患者最多，占比91.67%，年龄与肺动脉血栓栓塞猝死的联系密切，呈正相关（r=0.425，P＜0.05）；12例肺动脉血栓栓塞猝死患者中，反复性栓塞患者共8例，占比66.67%。一次性栓塞患者共4例，占比33.33%。栓子来源于下肢深静脉共7例，占比58.33%。栓子来源于右心室共5例，占比41.67%。结论 肺动脉血栓栓塞猝死患者的法医尸检报告及病理性资料明确标注了肺动脉血栓栓塞猝死的诱发原因及栓子来源，可为临床减少肺动脉血栓栓塞猝死风险，以及刑侦、司法鉴定提供重要依据。

Abstract

Objective To analyze the forensic pathological characteristics of sudden death caused by pulmonary embolism.
Methods Twelve patients with sudden death caused by pulmonary embolism confirmed by forensic autopsy from August 2023 to August 2024 were selected as the research subjects. The clinical data, forensic autopsy reports, pathological data, etc. of all patients were retrospectively analyzed, and the causes of sudden death and the sources of emboli were studied and analyzed.
Results According to the relevant forensic autopsy report, among the 12 patients with sudden death caused by pulmonary embolism, one patient had an unclear cause of sudden death, while the other 11 patients had clear causes of sudden death; The majority of patients are over 50 years old, accounting for 91.67%. Age is closely related to sudden death due to pulmonary embolism, with a positive correlation (r=0.425, P<0.05). Among the 12 patients with sudden death due to pulmonary embolism, there were a total of 8 patients with recurrent embolism, accounting for 66.67%. There were 4 cases of one-time embolism patients, accounting for 33.33%. There were 7 cases of emboli originating from deep veins in the lower limbs, accounting for 58.33%. There were 5 cases of emboli originating from the right ventricle, accounting for 41.67%.
Conclusion   The forensic autopsy report and pathological data of patients with sudden death caused by pulmonary embolism clearly indicate the triggering causes and sources of emboli, which can provide important evidence for reducing the risk of sudden death caused by pulmonary embolism in clinical practice, as well as for criminal investigation and judicial appraisal.