婴幼儿58例死亡原因尸检病理和医疗纠纷原因分析

摘要

目的 探讨婴幼儿死亡原因并分析其误诊及医疗纠纷产生的原因,为今后临床提高诊断正确率,减少婴幼儿病死率及预防医疗纠纷的发生提供帮助.方法 收集整理遵义医学院附属医院病理科2008年1月至2012年12月5年间尸检档案中婴幼儿病死亡医疗纠纷尸检病理报告资料.共58例,其中男39例,女19例;年龄0～3岁.结果 5年间每年发生婴幼儿死亡医疗纠纷案例分别为8例、10例、10例、15例、15例,总体呈上升趋势.婴幼儿病死率随年龄的增加而呈下降趋势,病死率最高是婴儿期,占婴幼儿死亡案例77.59％(45/58例).婴幼儿死亡原因最常见的是肺炎,占15.52％(9/58例);而新生儿的死亡原因以新生儿窒息最多见(27.27％,6/22例).在婴幼儿死亡病例发生误诊、漏诊的疾病中,以呼吸系统疾病最多见(57.89％,22/38例).结论 婴幼儿的病死率逐年下降,但是婴幼儿死亡所引发的医疗纠纷却呈上升趋势.各种类型的肺炎是婴幼儿最常见的死因,也是引起医疗纠纷的主要原因.%Objective To investigate the causes of infant mortality and analyze the reasons of misdiagnosis and medical disputes,and to provide help for improving clinical diagnostic accuracy in future in order to decrease the infant mortality and prevent the occurrence of medical tangle.Methods To collect and reorganize the autopsy pathology reports of medical tangle of infant deaths in the autopsy files of the Pathology Department of Affiliated Hospital of Zunyi Medical College within 5 years from Jan.2008 to Dec.2012,and a total of 58 cases were collected,of whom 39 cases were male and 19 cases were female,and the ages of these cases ranged from 0 to 3 years old.Results In 5 years,the number of medical tangle of infant deaths were 8 cases,10 cases,10 cases,15 cases and 15 cases,respectively,which showed an increasing trend on the whole.Infant mortality showed a significant decrease with the increase of age,as the highest mortality was the baby,which accounted for 77.59％ (45/58 cases) of infant deaths.The most common cause of infant death was pneumonia,which accounted for 15.52％ (9/58 cases) of all diseases,and neonatal asphyxia was the top cause of newborn infant deaths (27.27％,6/22 cases).In the cases of misdiagnosis and missed diagnosis of infant deaths,the respiratory system disease was the most common disease (57.89％,22/38 cases).Conclusions Infant mortality decreased year by year in clinical medicine,but there was an upward trend of medical disputes in infant deaths.Various types of pneumonia was the most common cause of infant deaths,and it was also the main cause contributing to medical tangles of infant deaths.