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目的:对一例全身大面积机械性损伤致死及由之所致的多系统器官衰竭死亡病例的相关问题进行讨论分析。方法:回顾性分析该病例的临床资料并对其行详细认真的尸体检验与死因鉴定。结果:本案尸检、临床所见及相关实验室检查已证实伤者因钝性暴力作用于全身软组织致使大面积软组织挫伤,多发性肋骨骨折并因多系统器官功能衰竭死亡。讨论:在整个病程中多器官系统的功能衰竭并非各自独立分别发生,而是互相影响,互相作用甚至互为因果恶性循环的结果,这在本例的临床病历资料中已充分体现。因此,在进行机械性损伤致死的法医学鉴定中,应注意区分多系统器官功能衰竭和挤压综合症的鉴别问题。
OBJECTIVE: To discuss and analyze a case of death caused by large-scale mechanical injury and the death of multiple system organ failure caused by it. Methods: The clinical data of this case were retrospectively analyzed and the detailed autopsy and the cause of death were performed. Results: The autopsy, clinical findings and related laboratory tests confirmed that the injured person suffered from massive soft tissue contusion, multiple rib fractures and death due to multiple system organ failure due to blunt violence on whole body soft tissues. Discussion: In the whole course of disease, multiple organ system failure does not occur independently of each other, but mutual influence, interaction and even the result of each other vicious cycle of causality, which in this case clinical medical records have been fully reflected. Therefore, in the forensic identification of death caused by mechanical injury, should pay attention to distinguish between multi-system organ failure and compression syndrome identification problems.