主管：中华人民共和国司法部
主办：司法鉴定科学研究院
ISSN 1671-2072  CN 31-1863/N
中国司法鉴定

中国司法鉴定 ›› 2024 ›› Issue (4): 49-53.DOI: 10.3969/j.issn.1671-2072.2024.04.006

• 鉴定综述 • 上一篇    下一篇

创伤性肺脂肪栓塞的法医病理学研究进展及其鉴定应用

贾宇晴1，2，姚承谕1，毛瑞明3，王天琦1，4，张孟周4，刘技辉1，朱宝利1，曹志鹏5   

  1. 1. 辽宁大学 司法鉴定研究院，辽宁 沈阳 110031； 2. 德国海德堡大学医院 法医学与交通医学研究所，
    德国 海德堡 69115； 3. 辽宁省公安厅刑事技术总队，辽宁 沈阳 110032； 4. 中国政法大学 证据科学教育部
    重点实验室，北京 100088； 5. 中国医科大学 法医学院 法医病理学教研室，辽宁 沈阳 110122
  • 收稿日期:2022-11-14 出版日期:2024-07-15 发布日期:2024-07-16
  • 通讯作者: 曹志鹏
  • 作者简介:贾宇晴（1992—），男，博士研究生，主要从事法医病理学研究及鉴定工作。E-mail：jia214@hotmail.com

Advances in the Forensic Pathology of Traumatic Pulmonary Fat Embolism and Its Identification Application

JIA Yuqing1,2, YAO Chengyu1, MAO Ruiming3, WANG Tianqi1,4, ZHANG Mengzhou4, LIU Jihui1, ZHU Baoli1, CAO Zhipeng5   

  1. 1. Academy of Forensic Science, Liaoning University, Shenyang 110031, China; 2. Institute of Forensic and Traffic Medicine, Heidelberg University Hospital, Heidelberg 69115, Germany; 3. Liaoning Provincial Public Security 
    Department Criminal Technology Headquarters, Shenyang 110032, China; 4. Key Laboratory of Evidence Science, 
    Ministry of Education, China University of Political Science and Law, Beijing 100088, China; 5. Department of 
    Forensic Pathology, School of Forensic Medicine, China Medical University, Shenyang 110122, China
  • Received:2022-11-14 Published:2024-07-15 Online:2024-07-16

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摘要： 肺脂肪栓塞（pulmonary fat embolism，PFE）是骨折、广泛脂肪组织损伤后常见的继发性病理形态学改变，骨折等创伤后总发生率可达82%~93%。临床常规检查仍无法特异性诊断，加之起病隐匿急骤，因此目前仍以死后组织病理学检查为金标准。创伤性肺脂肪栓塞是否参与死亡、与死亡间的因果关系及伤病关系等均是法医实际工作中常面临的问题。以创伤性PFE的严重程度评估、死后诊断原则为主要综述内容，并总结了其检查方法、骨科手术及心肺复苏的影响等常见问题，以期为创伤性肺脂肪栓塞的法医学鉴定及研究提供参考。

关键词:  , 法医病理学, 肺脂肪栓塞, 脂肪栓塞综合征, Falzi分级, 心肺复苏

Abstract: Pulmonary fat embolism (PFE) is a common secondary pathomorphological change after fracture and extensive adipose tissue injury, with an overall incidence of 82%-93% after trauma such as fracture. Due to lack of specific diagnosis through routine clinical examination and the inapparent and sudden onset of the disease, post-mortem histopathological examination is still used as the standard at present. Whether traumatic PFE is involved in death, its causal relationship with death, and the relationship between injury and disease are common issues faced in forensic practice. This review focuses on the assessment of the severity of traumatic PFE and the principles of post-mortem diagnosis. It summarizes common issues such as examination methods, orthopedic surgery, and the impact of cardiopulmonary resuscitation, in order to provide reference for forensic identification and research on traumatic PFE.

Key words: forensic pathology, pulmonary fat embolism (PFE), fat embolism syndrome, Falzi’s grading, cardiopulmonary resuscitation

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