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心脏传导系统病变致猝死的诊断依据

时间:2022-04-16 理论教育 版权反馈
【摘要】:确定为心脏传导系统病变致猝死的法医学鉴定不可脱离案情而作出。如一例见有明显CCS发育异常的青年人,有头面部受打击、晕倒,当即死亡案情,脑干病理检查见明显损伤,鉴定为原发性脑干损伤致死。,1990,44:272-282.[18]COHLE S D,LEI J T.Pathologic changes of the cardiac conduction tissue in sudden unexpected death[J].A review Ann Pathol,1991,Pt 226:33-57.[19]JAMES T N,MARSHALL T K.De subitaneis Mortibus.ⅩⅦ.Multifocal stenoses due to fibromuscular dysplasia of the sinus node artery[J].Circulation,1976,53:736-737.[20]BHARATI S,LEV M.Congenital abnormalities of the conduction system in sudden

第五节 心脏传导系统病变致猝死的诊断依据

确定为心脏传导系统病变致猝死的法医学鉴定不可脱离案情而作出。因为有的心律失常猝死者CCS检查不一定都有病变;反之,有病变不一定都确定是死亡原因。如一例见有明显CCS发育异常的青年人,有头面部受打击、晕倒,当即死亡案情,脑干病理检查见明显损伤,鉴定为原发性脑干损伤致死。为此,要作CCS病变致猝死的法医学鉴定时,必须掌握好以下的鉴定依据:①没有可致死亡的暴力作用;②头面部和躯干有暴力打击者一定要除外原发性脑干损伤致死;③排除中毒致死;④无心外原因致猝死;⑤除CCS病变外,心脏其余部位未检见致死病变;⑥心脏和CCS均有病变,但CCS更严重;⑦CCS具有足以解释死亡原因的病变。

(宋一璇 罗 斌)

参 考 文 献

[1]LEV M,BHARATI S.A method of study of the pathology of the conduction system for electrocardiographic and His bundle electrogram correlations[J].The Anatomical Record,1981,20:43-49.

[2]CHARLTO I,WILLIAMS R.Cardiac comducting tissue——a simplified technique examination of the SA and AV nodes[J].Am J Forensic Med and Pathol,1990,11:213-218.

[3]宋一璇,姚青松,罗斌,等.心传导系统(CCS)检查法、年龄变化及其与猝死关系[J].医学研究通讯,1997,26(3):24-26.

[4]罗斌,宋一璇,DICKENS P,等.人心传导系统纵切取材法及组织学观察[J].解剖学报,1997,28(4):379-381.

[5]JAMES T N.Normal and abnormal consequences of apoptosis in the human heart[J].Circulation,1994,90(1):556-573.

[6]罗斌,宋一璇,姚青松,等.窦房结主、间质形态学改变与年龄的相关研究[J].中华心血管病杂志,1995,23(4):288-291.

[7]宋一璇,姚青松,王慧君,等.成人心传导系统的超微结构[J].解剖学研究,2002,24(1):21-23.

[8]姚青松,宋一璇,梁尚猷,等.心脏房室连接区出血四例尸检报告[J].中国法医学杂志,1992,7(3):175-176.

[9]JAMES T N,ZIPES D P,FINEGAN R E,et al.Observation on the pathophysiology of the long QT syndromes with special reference to the neuropathology of the heart[J].Circulation,1978,57:1 221.

[10]ANDRADE Z A,ANDRAD S G,OLIVEA G B,et al.Histopathology of the couducting tissue of the heart in Chaga's Myocarditis[J].Am Heart J,1978,95(3):316-324.

[11]GAY J D,GUILEYARDO J M,TOWNSEND-PARCHMAN J K,et al.Clinical and morphologic features of Lipomatous hypertrophy(“massive fotty deposits”)of the interatril seotum[J].Am J Forensic Med Pathol,1996,17:43-48.

[12]JAMES T N,CARSON D L,MARSHALL T K.Fibroma compressing his bundle[J].Circulation,1973,48:428-433.

[13]JAMES T N,BEESON C W,SHERMAN E B,et al.Multifocal Purkinje cell tumors of the heart[J].Circulation,1975,52:333-344.

[14]JAMES T N.Cardiac conduction system,fetal and postnatal development[J].Am J Cardiol,1970,25: 213.

[15]宋一璇,姚青松,罗斌,等.心脏传导系统肿瘤的形态观察[J].中华病理学杂志,1998,27:10-12.

[16]宋一璇,姚青松,罗斌,等.房室传导系统发育异常猝死的病理学研究[J].中国法医学杂志,1994,9(4):203-205.

[17]舜田博文.法医解剖急死例における刺激碝导系を含を心脏の病理组织学的研究[J].日法医?,1990,44(4):272-282.

[18]COHLE S D,LEI J T.Pathologic changes of the cardiac conduction tissue in sudden unexpected death[J].A review Ann Pathol,1991,Pt 226:33-57.

[19]JAMES T N,MARSHALL T K.De subitaneis Mortibus.ⅩⅦ.Multifocal stenoses due to fibromuscular dysplasia of the sinus node artery[J].Circulation,1976,53:736-737.

[20]BHARATI S,LEV M.Congenital abnormalities of the conduction system in sudden death in young adults[J].J Am Coll Cardiaol,1986,8:1096.

[21]宋一璇,姚青松,罗斌,等.54例心源性猝死患者心传导系统病变的分析[J].中华病理学杂志,1999,28(3):187-190.

[22]JAMES T N.Degenerative lesions of a coronary chemoreceptor and nearby neural elements in the heart of victims of sudden death[J].J Am Coll Cardiol,1986,8:12-21.

[23]SUAREZ-MIER M P,FERNANDEZ-SIMON L,GAWALLO C.Pathologic changes of the cardiac conduction tissue in sudden cardiac death[J].Am J Forensic Med Pathol,1995,16:193-202.

[24]姚青松,宋一璇,祝家镇,等.肥厚性心肌病心传导系统病理学观察[J].中华心血管病杂志,1996,24(2):143-145.

[25]MYERBURG R J,KESSLER K M,CASTELLANOS A.Sudden cardiac death,structure,function,and timedependence of risk[J].Circulation(Supplement 1),1992,85(1):1-10.

[26]梁赏猷,宋一璇,姚青松,等.120例心性猝死心传导系统观察分析[J].中国法医学杂志,1998,13(2):105-107.

[27]姚青松,宋一璇.青年人CCS脂肪超前变化致猝死[J].中国法医学杂志,1998,13(1):12-14.

[28]宋一璇,姚青松,祝家镇,等.心脏神经病[J].中国法医学杂志,2002,17(5):274-276.

[29]宋一璇,姚青松,高修仁,等.12例心电图异常患者的传导系统病理改变观察[J].中华心血管病杂志,2006,34(3):231-235.

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