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style="text-indent:24.0pt;"> <br /> </p> <p class="MsoNormal" style="text-indent:28.1pt;"> <b><span style="font-size:14pt;font-family:宋体;line-height:2;">2011</span></b><b><span style="font-size:14.0pt;font-family:宋体;"><span style="line-height:2;">?/span><span style="line-height:2;">1</span><span style="line-height:2;">?/span><span style="line-height:2;">13</span><span style="line-height:2;">?/span><span style="line-height:2;">9</span><span style="line-height:2;">时,孕妇李某因“停?/span><span style="line-height:2;">9</span><span style="line-height:2;">月余,腹坠痛</span><span style="line-height:2;">1</span><span style="line-height:2;">天”到某县妇幼保健院就诊,该院经检查以“巨大儿?/span><span style="line-height:2;">G2P1</span><span style="line-height:2;">宫内?/span><span style="line-height:2;">41</span><span style="line-height:2;">周;</span><span style="line-height:2;">ROA</span><span style="line-height:2;">;先兆临产”收入院。当?/span><span style="line-height:2;">10</span><span style="line-height:2;">时许送入手术室拟行连硬外麻醉下新式剖宫产术,麻醉达成后改变体位约</span><span style="line-height:2;">3</span><span style="line-height:2;">分钟出现呼吸停止、心跳减慢,经抢救无效于当日</span><span style="line-height:2;">11</span><span style="line-height:2;">时许在该院因抢救无效宣布临床死亡,其子在宫内死亡?/span><span></span></span></b> </p> <p class="MsoNormal" style="text-indent:28.1pt;"> <b><span style="font-size:14.0pt;font-family:宋体;"><span style="line-height:2;">?/span><span style="line-height:2;">2011</span><span style="line-height:2;">?/span><span style="line-height:2;">1</span><span style="line-height:2;">?/span><span style="line-height:2;">13</span><span style="line-height:2;">日某县妇幼保健院麻醉记录载:病人</span><span style="line-height:2;">10:10</span><span style="line-height:2;">进入手术室,常规吸氧,测血?/span><span style="line-height:2;">120/80mmHg</span><span style="line-height:2;">,脉?/span><span style="line-height:2;">70</span><span style="line-height:2;">?/span><span style="line-height:2;">/</span><span style="line-height:2;">分,呼吸</span><span style="line-height:2;">20</span><span style="line-height:2;">?/span><span style="line-height:2;">/</span><span style="line-height:2;">分,取左侧卧位行硬膜外麻醉,?/span><span style="line-height:2;">L1</span><span style="line-height:2;">­</span><span style="line-height:2;">-2</span><span style="line-height:2;">?/span><span style="line-height:2;">2%</span><span style="line-height:2;">利多卡因做皮丘进行穿刺,进有?/span><span style="line-height:2;">4cm</span><span style="line-height:2;">有落空感,回吸无血液或液体,空气试验无阻力,给?/span><span style="line-height:2;">2%</span><span style="line-height:2;">利多卡因做试验量,续入软?/span><span style="line-height:2;">4cm</span><span style="line-height:2;">,管内无血液或液体流出,固定软管后,病人翻身平卧,</span><span style="line-height:2;">3</span><span style="line-height:2;">分钟后发现病人嘴唇紫绀,呼之不应,心电监护显示心率</span><span style="line-height:2;">30</span><span style="line-height:2;">?/span><span style="line-height:2;">/</span><span style="line-height:2;">分,血压未显示,无呼吸,立即给予气管插管、心脏按摩、肾上腺素、可拉明、洛贝林、阿托品,并求助县医院麻醉科与内科主任共同抢救?/span><span></span></span></b> </p> <p class="MsoNormal" style="text-indent:28.1pt;"> <b><span style="font-size:14.0pt;font-family:宋体;"><span style="line-height:2;">尸检见左肘窝?/span><span style="line-height:2;">1</span><span style="line-height:2;">处注射针孔,周围见大?/span><span style="line-height:2;">0.5cm</span><span style="line-height:2;">×</span><span style="line-height:2;">0.7cm</span><span style="line-height:2;">的皮下青紫,左手背部?/span><span style="line-height:2;">2</span><span style="line-height:2;">处注射针孔,周围见大?/span><span style="line-height:2;">3cm</span><span style="line-height:2;">×</span><span style="line-height:2;">4cm</span><span style="line-height:2;">皮下青紫,右手背?/span><span style="line-height:2;">1</span><span style="line-height:2;">处注射针孔,周围见大?/span><span style="line-height:2;">4cm</span><span style="line-height:2;">×</span><span style="line-height:2;">4cm</span><span style="line-height:2;">的皮下青紫。胸部及下腹部见尸绿,腹?/span><span style="line-height:2;">109cm</span><span style="line-height:2;">,双下肢呈凹陷性水肿,背部?/span><span style="line-height:2;">1-2</span><span style="line-height:2;">腰椎间见麻醉穿刺?/span><span style="line-height:2;">1</span><span style="line-height:2;">处。切开头皮,头皮无损伤及出血,左、右颞肌无出血,颅骨无骨折,颅内无出血?/span><span></span></span></b> </p> <p class="MsoNormal" style="text-indent:28.1pt;"> <b><span style="font-size:14.0pt;font-family:宋体;"><span style="line-height:2;">颈部皮肤及各肌群无损伤,剪开喉头,喉头无水肿、呈充血状,舌骨及甲状软骨无骨折。胸壁无损伤,分离胸部皮下肌肉,胸骨及肋骨无骨折,打开胸腔,左、右侧胸腔内干净。胸腹腔各器官肉眼观未见异常?/span><span></span></span></b> </p> <p class="MsoNormal" style="text-indent:28.1pt;"> <b><span style="font-size:14.0pt;font-family:宋体;"><span style="line-height:2;">纵向切开子宫,羊膜未破,宫腔内见混浊羊水?/span><span style="line-height:2;">420ml</span><span style="line-height:2;">,胎儿已死亡,为男婴,呈枕右前位,头部已入盆,脐带长</span><span style="line-height:2;">55cm</span><span style="line-height:2;">,无扭转及假结,胎盘附着于子宫后壁,人工剥离胎盘,胎盘完整,大小</span><span style="line-height:2;">21cm</span><span style="line-height:2;">×</span><span style="line-height:2;">18cm</span><span style="line-height:2;">×</span><span style="line-height:2;">2.5cm</span><span style="line-height:2;">?/span><span></span></span></b> </p> <p class="MsoNormal" style="text-indent:28.1pt;"> <b><span style="font-size:14.0pt;font-family:宋体;"><span style="line-height:2;">胎盘?/span><span style="line-height:2;">440</span><span style="line-height:2;">克,大小</span><span style="line-height:2;">21cm</span><span style="line-height:2;">×</span><span style="line-height:2;">18cm</span><span style="line-height:2;">×</span><span style="line-height:2;">2.5cm</span><span style="line-height:2;">,剥离完整。镜下胎盘绒毛发育正常,部分胎盘绒毛变性,有的区域见坏死及出血?/span><span></span></span></b> </p> <p class="MsoNormal" style="text-indent:28.1pt;"> <b><span style="font-size:14.0pt;font-family:宋体;"><span style="line-height:2;">脐带?/span><span style="line-height:2;">55cm</span><span style="line-height:2;">,无扭曲,镜下脐动脉、静脉未见异常?/span><span></span></span></b> </p> <p class="MsoNormal" style="text-indent:28.1pt;"> <b><span style="font-size:14.0pt;font-family:宋体;"><span style="line-height:2;">沿脊柱纵向分层切开并分离背部皮肤及肌肉,第</span><span style="line-height:2;">1-2</span><span style="line-height:2;">腰椎间麻醉穿刺孔处局部皮下组织及深部脊柱旁肌肉组织见出血,打开脊髓腔,取胸</span><span style="line-height:2;">10</span><span style="line-height:2;">到腰</span><span style="line-height:2;">5</span><span style="line-height:2;">平面硬脊膜及脊髓。沿脊髓前侧完整剥离脊髓硬膜,其上与麻醉注射处相对应处检见一圆形小米粒大小孔洞;脊髓镜下蛛网膜下腔小血管扩张、淤血及点灶性出血,脊髓内小血管扩张、水肿及神经细胞水肿?/span><span></span></span></b> </p> <p class="MsoNormal" style="text-indent:28.1pt;"> <b><span style="font-size:14.0pt;font-family:宋体;"><span style="line-height:2;">毒化检验:死者脑脊液经本鉴定中心检验,其利多卡因含量为?/span><span style="line-height:2;">0.78mg/mL</span><span style="line-height:2;">。死者之心血经检验,其血清中总免疫球蛋白</span><span style="line-height:2;">E</span><span style="line-height:2;">为:</span><span style="line-height:2;">101.51IU/ml</span><span style="line-height:2;">(正常参考?/span><span style="line-height:2;">1.31-165.30IU/ml</span><span style="line-height:2;">)?/span><span></span></span></b> </p> <p class="MsoNormal" style="text-indent:28.1pt;"> <b><span style="font-size:14.0pt;font-family:宋体;"><span style="line-height:2;">鉴定分析?/span><span></span></span></b> </p> <p class="MsoNormal" style="text-indent:28.1pt;"> <b><span style="font-size:14.0pt;font-family:宋体;"><span style="line-height:2;">?/span><span style="line-height:2;">1</span><span style="line-height:2;">)根据对死者尸检及器官组织的法医病理学检查结果,其喉头无水肿,喉头及其他脏器粘膜、浆膜未检见嗜酸性粒细胞渗出,心血中总免疫球蛋白</span><span style="line-height:2;">E</span><span style="line-height:2;">在正常值范围内,认为可排除其因药物过敏性休克所致死亡?/span><span></span></span></b> </p> <p class="MsoNormal" style="text-indent:28.1pt;"> <b><span style="font-size:14.0pt;font-family:宋体;"><span style="line-height:2;">?/span><span style="line-height:2;">2</span><span style="line-height:2;">)根据对死者尸检及器官组织的法医病理学检查结果,其背部腰</span><span style="line-height:2;">1-2</span><span style="line-height:2;">椎间见针孔,局部皮下及脊柱旁肌肉组织见出血,打开脊髓腔、分离脊髓,其腰</span><span style="line-height:2;">1-2</span><span style="line-height:2;">椎间硬脊膜见针孔,脊髓见水肿;而全身其余各脏器除检见淤血、水肿等急性死亡的一般病理形态学改变外,未检见其它致死性形态学异常;肺淤血,灶性水肿、气肿及多发性片状肺出血;结合实验室化验结果及死亡经过综合分析,认为李蜜果符合因连硬外麻意外误注脊髓蛛网膜下腔致全脊髓麻醉而死亡?/span><span></span></span></b> </p> <p class="MsoNormal" style="text-indent:28.1pt;"> <b><span style="font-size:14.0pt;font-family:宋体;"><span style="line-height:2;">?/span><span style="line-height:2;">3</span><span style="line-height:2;">)根据对死者之子尸检及器官组织的法医病理学检查结果,其肺浮扬试验为阳性,肺组织内检见较多羊水成份,肺呈多发性片状出血;余全身各脏器未发现有致死性先天性发育异常,结合其死亡经过综合分析,认为李某之子符合因宫内窒息而死亡?/span><span></span></span></b> </p> <p> <br /> </p> <p> <br /> </p></p> </div></div> </div> </div> </div> </div> </div> <div class="Footbg"> <div class="wrapper"> <div class="FootNav"> <dl class="FootListOne Colorfff"> <dt>政策法规</dt> <dd> <a href="/html/info1027..10341117.html" 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