气管切开术后并发气管无名动脉瘘的法医学初探

目的探讨气管切开术后并发气管无名动脉瘘的发生机理。方法结合案例对气管与无名动脉的解剖学关系和临床上气管无名动脉瘘的主要原因进行分析。结果气管切开术后并发气管无名动脉瘘的主要原因是低位气管切开、术后体位不当。在正确的气管切开切口位置实施手术操作及术后体位的正确保持护理，是避免气管切开术后并发气管无名动脉瘘的关键。结论本鉴定案例中，重型颅脑损伤是主要死因及间接死因，气管切开术后并发气管无名动脉瘘致无名动脉破裂大失血是直接死因。

The forensic medicine study on trachea arteria anonyma fistula after tracheotomy

Objective To discuss genesic mechanism of trachea arteria anonyma fistula after tracheotomy. Methods Analyze the anatomy relation of the trachea and the arteria anonyma and the main reasons of trachea arteria anonyma fistula in clinical through the case.Results The main reasons of trachea arteria anonyma fistula after tracheotomy are cutting open the trachea at the lower position and a unmerited posture of body after the surgery. To do surgical operations at a accurate notch position and the right nursing of posture of body are the key to avoid trachea arteria anonyma fistula after tracheotomy.Conclusion Severe craniocerebral trauma is main cause of death and indirect cause of death and arteria anonyma massive hemorrhage coming from trachea arteria anonyma fistula is direct cause of death in this case example.