意外电击致死16例尸检病理分析

目的 探讨电击致死的诊断依据.方法 收集2001年1月-2008年7月受理的16例意外电击致死法医尸检案例.采用大体观察和HE镜下观察.结果 16例意外电击致死尸检肉眼具典型电流斑者仅5例,光镜下典型电流斑11例.非典型电流斑形态多样化,以单纯性表皮剥脱和颜色改变多见.体内器官病理变化主要为心肌纤维排列紊乱、断裂较明显和部分案例心肌间质灶性出血和血管内皮细胞极性化改变.结论 光镜下皮肤电流损伤是诊断电击致死的主要依据;而心肌的病理改变具有一定的辅助诊断意义.

Pathology of accidental electrocution: an autopsy study of 16 cases

Objective To study the pathologic findings seen in lethal cases due to accidental electrocution.Methods The macroscopic and microscopic findings in 16 autopsy cases died of electrocution encountered during the period from January, 2001 to July, 2008 were retrospectively reviewed.Results Typical electric marks were found on gross examination in 5 of the 16 cases studied.Histologically, 11 of the 16 cases showed evidence of electric burn.The morpholagic features of atypical electric marks varied.Simple epidermal exfoliation and color changes were relatively common.Pathologic changes in internal viscera included disarray of myocardial fibers.Rupture of myocardial fibers was readily identified than in non-electrocution death.Sometimes, focal interstitial hemorrhage and polarization of endothelial cells were seen.Conclusions The electric marks on the skin, as confirmed by histologic examination, remain important sequelae of electrocution.The pathologic changes seen in myocardium provide additional clues to the diagnosis.