【摘要】 目的探讨医疗纠纷尸检中过敏性休克死亡的特点和病理诊断要求。方法对我校病理解剖学教研室近十年264例医疗纠纷尸检病例做了回顾性研究,配以组织中肥大细胞染色和死者血清中IgE检查。结果264例尸检例中有63例在输液体过程中或输液后3小时内突然死亡。甲苯胺蓝染色见肥大细胞脱颗粒现象而确诊为过敏的25例,占突然死病例的39.7%;其余38例病例死于心血管疾病,占突然死病例的60.3%。尸检时过敏病例心脏血IgE检验值均分布在0-48.8IU/ml之间,小于临床判定过敏反应的参考值。结论在医疗纠纷由于输液引起过敏导致死亡的病例占相当的比例,尸检病例心脏血IgE检查对诊断过敏的帮助和意义有待于进一步讨论。更多还原

【Abstract】 Objective Study on the characteristics of died-cases with allergic shock in Autopsy and their pathological diagnosis criteria.Methods Review study 264 autopsy cases in our department of recent 10 years and helped with mast cell special staining.Results The 63 cases of 264 autopsies were suddenly died during intra-venous injection or in3 hours after intra-venous injection.Mast cell special staining showed that there were 25 cases with mast cell releasing granules and were diagnosed as allergic shock.The percentage of allergic case on 63 cases with suddenly died was 39.7%.The other 38 suddenly died case were died with cardiovascular disease,and occupied 60.3%.The serum IgE level in all allergic cases were around 0-48.8I U/ml and were all less than the valve for the clinical reference for allergenic reaction.Conclusion There was a relatively ration cases with allergic shock related to intra-venous injection in autopsy.The reference value and its significance of serum IgE level inallergic shock diagnosis on autopsy need further discussion更多还原