本文選題：中毒　切入點：尸檢資料　出處：《華中科技大學》2009年碩士論文

【摘要】：【研究背景】中毒死亡為與機械性損傷、機械性窒息、猝死及其他原因(如電擊、高低溫損傷等)同等重要的死亡原因。法醫(yī)毒理病理學研究的重點和難點,包括對常見毒物性狀、種類、中毒原因、毒理作用、中毒量和致死量、中毒血濃度和致死血濃度、中毒所致病變、毒物化驗檢材采取、保存、送檢、中毒或中毒死亡方式的法醫(yī)學鑒定等方面的研究。大多數(shù)的文獻資料僅對個別的中毒死亡案例進行報道分析,或者是對單一毒物的深入研究,缺乏對中毒死亡案例的橫向對比研究,和對中毒的宏觀把握、發(fā)展趨勢預測及相關因素對中毒致死案例影響的分析。 近年來,許多學者通過案例收集、分類匯總并作橫向對比,對中毒死亡這一類案例進行研究,為中毒案件的死因鑒定、偵查破案提供了重要的依據。隨著我國科學技術的發(fā)展,特別是農藥制作技術、中醫(yī)藥檢測技術的發(fā)展、催眠鎮(zhèn)靜安定類藥物及毒品濫用的增加等,中毒案件出現(xiàn)了一些新的變化和發(fā)展。本課題收集本單位實際工作中的案例,對各類中毒案例的數(shù)量變化趨勢、中毒死亡者的年齡分布及中毒途徑等方面進行對比研究,為中毒案例的實際鑒定工作提供理論依據,并為中毒事件的預防工作作出貢獻。 【目的】本課題選用作者單位1957年～2008年實際檢案中的中毒案例605例,通過統(tǒng)計學方法對收集資料進行對比研究,分析不同年份中毒案例所占比例的變化情況,中毒死亡者年齡分布情況,毒物種類在不同年份的變化發(fā)展情況,并對這些變化規(guī)律進行原因分析,為法醫(yī)學鑒定提供理論依據。 【材料與方法】對華中科技大學同濟醫(yī)學院法醫(yī)學系法醫(yī)病理教研室1999年1月~2008年12月(以下簡稱C組)檢驗的、且均經系統(tǒng)尸檢和病理組織學檢查的各種中毒案例216例,除作一般統(tǒng)計學分析外,著重對毒物種類特點、中毒途徑、中毒方式等問題進行分析探討,并與本單位1983年~1998年(以下簡稱B組)的158例中毒資料,及1957年~1982年(以下簡稱A組)的231例中毒資料進行比較。 【結果】①C組與A、B組相比,中毒案例的相對數(shù)量呈減少趨勢;②中毒死亡者以男性居多,且以青壯年為主;③毒物種類上傳統(tǒng)農藥中毒案例呈遞減趨勢,而新型農藥顯著增加;④兩種或兩種以上藥(毒)物中毒的數(shù)量顯著增加,進行毒化分析時應重點注意,尤其是單一成份中毒達不到致死濃度時,應考慮兩種及兩種以上成份中毒時的毒物協(xié)同作用的可能;⑤中毒途徑上,口服中毒案例減少,呼吸道中毒案例顯著增加;⑥中毒在各類法醫(yī)檢案中仍占一定比例,因此不同年代和不同地區(qū)的中毒死亡案例的統(tǒng)計分析信息對于實踐具有一定指導意義。 【結論】本文案例資料顯示,中毒案例數(shù)量較以往有明顯增長趨勢,中毒死者年齡分布、毒物種類等方面均較以往有明顯變化,尤其多種毒物聯(lián)合應用所致中毒案件顯著增多。
[Abstract]:Background: poisoning death is an important cause of death as much as mechanical injury, mechanical asphyxia, sudden death and other causes (such as electric shock, high and low temperature injury, etc.). Including toxic properties, types, causes of poisoning, toxicological effects, toxic and lethal amounts, toxic blood concentrations and lethal blood concentrations, pathological changes caused by poisoning, toxicological tests, taking, preservation, and submission for inspection, The majority of the literature reports and analyses only individual cases of poisoning deaths, or the in-depth study of a single poison. There is a lack of horizontal comparative study of poisoning death cases, macroscopic grasp of poisoning, prediction of development trend and analysis of the influence of related factors on poisoning death cases. In recent years, many scholars have studied the death of poisoning cases through case collection, classification and horizontal comparison, and identified the cause of death of poisoning cases. With the development of science and technology in China, especially the development of pesticide production technology, the development of traditional Chinese medicine detection technology, the increase of hypnotic sedative and tranquilizing drugs and drug abuse, etc. There have been some new changes and developments in poisoning cases. This subject collects cases from the actual work of our unit, and makes a comparative study on the changing trend of the number of poisoning cases, the age distribution of poisoning deaths and the ways of poisoning, etc. To provide theoretical basis for the practical identification of poisoning cases, and to contribute to the prevention of poisoning incidents. [objective] to select 605 poisoning cases from 1957 to 2008, and to analyze the changes of the proportion of poisoning cases in different years by means of statistical method. The age distribution of poisoning victims, the changes and development of poison types in different years, and the causes of these changes were analyzed to provide a theoretical basis for forensic identification. [materials and methods] 216 cases of poisoning were examined in the Forensic Pathology Department of Tongji Medical College, Tongji Medical College, Huazhong University of Science and Technology from January 1999 to December 2008 (Group C), and were all examined by systematic autopsy and histopathological examination. In addition to general statistical analysis, the characteristics of toxicants, ways of poisoning, ways of poisoning and so on were analyzed and discussed. The data of 158 cases of poisoning from 1983 to 1998 (group B for short) in our unit were analyzed and discussed. And 231 cases of poisoning from 1957 to 1982 (group A) were compared. [results] 1Compared with group A B, the relative number of poisoning cases in group C showed a decreasing trend. However, the number of poisoning caused by two or more drugs (poisons) was significantly increased by the new pesticide, so we should pay more attention to the poisoning analysis, especially when the single component poisoning is not up to the lethal concentration. It is necessary to consider the possible toxic ways of synergism of two or more components. There are fewer cases of oral poisoning and a significant increase in cases of respiratory tract poisoning, which still account for a certain proportion of all kinds of forensic medical examination cases. Therefore, the statistical analysis information of poisoning death cases in different years and different regions has certain guiding significance for practice. [conclusion] the case data of this paper show that the number of poisoning cases is obviously increasing, the age distribution of poisoning victims and the types of poisons are obviously changed, especially the cases of poisoning caused by the combined use of many kinds of poisons are obviously increased.
【學位授予單位】：華中科技大學
【學位級別】：碩士
【學位授予年份】：2009
【分類號】：D919.2

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