胆囊手术相关医疗纠纷的法医学分析

目的:分析胆囊手术相关医疗纠纷案件的法医学特点,探讨其临床预防和鉴定要点。方法:对四川大学华西法医学鉴定中心1998年至2014年36例因胆囊手术诱发的医疗纠纷进行回顾性分析。结果:男性16例,女性20例;以41~60岁年龄组多见(63.89%);二级医院发生的医疗纠纷最多(58.33%);术前诊断以急慢性结石性胆囊炎为主(58.33%);术式以开腹手术为主(72.22%);主要死因为手术并发症(62.5%),其次心血管疾病(18.75%);术后3 d内死亡最易诱发医疗纠纷(62.5%)。结论:重视轻症胆囊炎患者的诊治、强化知情告知义务、加强手术并发症的防治有利于防范医疗纠纷;及时尸体解剖明确死因对解决医疗纠纷非常重要。

Forensic analysis on gallbladder surgery-related medical tangle

Objective:To analyze the forensic features,cause of medical tangle related with gallbladder surgery,provide preven-tive measures and explore medicolegal expertise. Methods:We retrospectively analyzed 34 cases medical tangle related with bile surger-y,All cases are assessed at the School of Forensic Medicine from 1998 to 2014. Results:16 cases were males, the other 20 were fe-males. The dominating age group was from 41 to 60 ( 63. 89%) . The dominating grade of hospital was secondary level hospital (58. 33%). The most common diagnosis before surgery was acute or chronic cholecystitis with gallstones(58. 33%). The dominating of first Surgical methods was open cholecystectomy(72. 22%). The majority of cause of death were operative complications(62. 5%),fol-lowed by cardiovascular disease(18. 75%). The majority of time of death were within3 days after cholecystectomy(62. 5%)Conclu-sion:It is important to improve doctors’ responsibility and surgical skills,strengthen the circumvention and treatment for the complica-tions,especially in patients with mild cholecystitis. And it is important to perform autopsy on the patients who died after the surgery and involved medical tangle.