冠状动脉支架植入术中死亡法医病理检验4例
Forensic pathology examination of death during intracoronary stenting:a report of four cases
毋静婷 1穆佳琦 1代号 1陈晓刚1
作者信息
- 1. 四川大学华西基础医学与法医学院,四川 成都 610041
- 折叠
摘要
目的 总结冠状动脉支架(coronary stent,CS)植入术中死亡者法医病理检验的要点.方法 回顾了4例CS植入术中死亡者法医病理尸检资料.结果 急性心肌梗死紧急行冠状动脉左旋支CS植入术1例,择期手术3例.发现冠状动脉夹层2例、血管破裂1例.冠状动脉破裂患者同时发现支架内急性血栓形成.三例患者5处新近安置CS部位血管狭窄程度较生前造影报告轻.未安置CS的血管生前造影检查报告的病变部位狭窄程度较死后病理检验重.结论 死后病理检验可有效检出冠状动脉损伤、支架血栓形成,但需解决冠状动脉腔内支架原始形态观察的难题.
Abstract
Objective To summarize the experience of forensic pathology examination of patients died during coronary stent(CS)implantation.Methods The records of 4 autopsies were reviewed to make a report.Results The CS implantation was performed emergently to treat acute myocardial infarction in 1 case.The other three CS implantations were scheduled.The coronary artery dissection was recorded in both clinical records and autopsy reports of 2 patients.The coronary artery rupture was recorded in the clinical and autopsy records of 1 patient.Acute CS thrombosis was also found in this patient during autopsy.In 3 patients,the degrees of vascular stenosis at the 5 sites of CS implantation in the autopsy reports were less than those in the ante-mortem angiography records.For the vascular stenosis observed in coronary artery without CS implantation,the degrees of vascular stenosis reported in the ante-mortem angiography record were greater than those in the post-mortem gross examination records.Conclusion Post-mortem pathological examination can effectively detect coronary artery injury and CS thrombosis.It is necessary to solve the problem of observing the structure and appearance of expanded CS intactly.
关键词
法医病理学/冠状动脉支架植入术/手术中死亡/冠状动脉病理检验Key words
Forensic pathology/Coronary stent implantation/Intraoperative death/Gross pathological examination of coronary引用本文复制引用
出版年
2024
NETL
NSTL
万方数据