Forensic pathological identification and analysis of 21 cases of drug-induced anaphylactic shock
21例药物过敏性休克死亡的法医病理学鉴定与分析

摘要

目的 分析药物过敏性休克死亡的法医病理学鉴定要点及相关因素。方法 对我院近10年来21例经法医病理学鉴定确诊为药物过敏性休克死亡的案例资料进行回顾性分析，总结分析其一般情况、用药情况、临床表现、病理形态学改变等情况。结果 死者中12例男性，9例女性；年龄范围为18 - 72岁。涉及的药物种类及例数包括：14例有抗生素、3例中药注射剂、3例生物制品、1例其他药物。从用药到出现症状的时间多在数分钟至半小时内。主要为呼吸困难、面色苍白、血压下降、意识丧失等临床表现。主要包括喉头及气管黏膜水肿、肺淤血水肿、内脏器官淤血等病理形态学改变。结论 药物过敏性休克死亡的法医病理学鉴定需综合考虑用药史、临床表现及病理形态学改变等多方面因素，准确把握鉴定要点，为案件的公正处理提供科学依据。

Abstract

Objective To analyze the forensic pathological identification points and related factors of drug induced shock death.
Methods A retrospective analysis was conducted on the data of 21 cases diagnosed as drug induced shock deaths by forensic pathology in our hospital in the past 10 years. The general information, medication use, clinical manifestations, pathological morphological changes, and other factors were summarized and analyzed. Among the deceased, there were 12 males and 9 females; The age range is 18-72 years old. The types and number of drugs involved include: 14 cases with antibiotics, 3 cases with traditional Chinese medicine injections, 3 cases with biological products, and 1 case with other drugs. The time from medication to symptom onset is usually within a few minutes to half an hour. The main clinical manifestations include difficulty breathing, pale complexion, decreased blood pressure, and loss of consciousness. Mainly including pathological morphological changes such as edema of the throat and tracheal mucosa, pulmonary congestion and edema, and internal organ congestion.
Conclusion   The forensic pathological identification of drug induced shock death requires comprehensive consideration of multiple factors such as medication history, clinical manifestations, and pathological morphological changes, accurately grasping the key points of identification, and providing scientific basis for the fair handling of the case.