胸部损伤伴胸腔创伤严重程度的法医鉴定

M. Gubin, V. Olkhovsky, E. Grygorian
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摘要

背景。闭合性胸部外伤合并肋骨骨折是一种常见的外呼吸系统损伤。有这种伤害的受害者可能要接受法医检查。这项研究的目的是确定在专门外科医院接受治疗的胸部闭合性创伤患者的损伤严重程度,为这种创伤的法医诊断建立额外的标准。研究对象和方法:在哈尔科夫以V.T.扎伊采娃命名的普通外科和急诊外科研究所治疗的71名住院患者的医疗卡。根据临床观察,对闭合性胸部损伤合并肋骨骨折的伤情进行法医学鉴定。采用形态学和临床方法确定损伤的严重程度。严重损伤14例(19.7%),主要发生危及生命的急性呼吸衰竭。57例(80.3%)胸部损伤合并肋骨骨折患者在无生命危险的情况下出现中度损伤。本文认为,在现有的科学和方法学文献中,尚没有诊断性的形态临床体征可用于定性的法医评估和预测闭合性胸部损伤的最终结果,对法医评估存在不同的看法。当应用法医鉴定的形态学和临床方法时,在确定损伤的严重程度时,应考虑闭合性胸部损伤的附加诊断标准:损伤后器官形态和功能变化的动态和恢复时间。或整个呼吸系统(肺),发生危及生命的现象。确定了进一步改进法医诊断的方法,以评估这些伤害的严重程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
FORENSIC MEDICAL DETERMINATION OF THE SEVERITY OF CHEST INJURIES WITH RIB CAGE TRAUMA
Background. Closed chest trauma with rib fractures is a common injury to the external respiratory system. Victims with such an injury may be subject to forensic examination. Purpose. The aim of the study was to determine the severity of injuries in patients with closed chest trauma with violation of the integrity of the costal skeleton, treated in a specialized surgical hospital, to establish additional criteria for forensic diagnosis of such trauma. Subjects and Methods. 71 medical cards of inpatients, patients with chest injuries who were treated at the Kharkiv Institute of General and Emergency Surgery named after V.T. Zaitseva. A forensic medical evaluation of closed chest injuries with rib fractures was performed according to the severity of injuries according to clinical observations. Morphological and clinical approach was used to determine the severity of injuries. Results. Severe injuries were found in 14 (19.7%) cases of injuries, mainly with the occurrence of a life-threatening phenomenon, namely acute respiratory failure. Moderate injuries were found in 57 (80.3%) cases of chest injuries with rib fractures in the absence of danger to life. Conclusions. It is established that in the available scientific and methodological literature there are no diagnostic morpho-clinical signs for qualitative forensic assessment and prediction of the final results of closed chest injuries, there are different views on forensic assessment. It is determined that when applying the morphological and clinical approach of forensic assessment, additional diagnostic criteria for closed chest injuries, should be considered when determining the severity of injuries: dynamics and duration of recovery of post-traumatic morphological and functional changes of injured organs. or the entire respiratory system (lungs), the occurrence of life-threatening phenomena. The ways of further improvement of forensic diagnostics in the assessment of these injuries by the degree of their severity are identified.
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