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Abstract
FORENSIС MEDICAL EXAMINATION IN NON-FATAL LARYNGEAL TRAUMA
Olkhovsky V.O., Gubin M.V., Grygorian E.K.
Victims with non-fatal laryngeal trauma become the object of forensic medical evaluation of the severity of bodily injuries in alive persons, carried out during pre-judicial and judicial investigation. The purpose of the study was to provide morphological and clinical analysis and characteristics of bodily injuries in cases of blunt laryngeal trauma in forensic medical examination of alive persons, to determine ways to improve the effectiveness of forensic medical diagnosis of the specified injury. Subjects and Methods. The study involved morphological and clinical analysis of 47 forensic medical expert conclusions in the leading forensic medical examination institution of Kharkiv region. Results. Frequency and types of blunt traumas of the larynx at examination of alive persons were determined. Specific features of forensic medical expert evaluation of bodily injuries severity in alive persons with blunt traumas of larynx were determined. Severe bodily injuries were defined in 3 cases (6.4 % of cases) of laryngeal traumas with the development of mechanical asphyxia. Moderate bodily injuries were determined by experts in 9 cases (19.1 % of cases) of blunt traumas of the larynx, accompanied by fractures of its cartilage; in 4 persons (8.5 % of cases) of blunt traumas of the larynx, accompanied by hematoma, edema of soft tissues of the larynx; in one case of blunt laryngeal trauma with acute edema, its second-degree stenosis. Mild bodily injuries which caused short-term disorder in 25 persons (53.2 % of cases) and mild bodily injuries which caused slight transitory effects in 4 persons (21.1 % of cases) were determined by experts in forensic medical examination of blunt laryngeal trauma with the development of acute posttraumatic laryngitis. The study implied elaboration of methods and an algorithm for improvement of forensic medical diagnostics in this type of injuries. Conclusions. Medico-legal diagnosis of blunt laryngeal trauma can be associated with underestimation and overestimation of the severity of bodily injuries by experts, which requires further research in the field of establishing unbiased expert diagnostic criteria for assessing such injuries.
Keywords: criteria of diagnosis, forensic medical examination, expert conclusion, laryngeal trauma.
Резюме
СУДОВО-МЕДИЧНА ЕКСПЕРТИЗА У ВИПАДКАХ НЕЛЕТАЛЬНИХ ТРАВМ ГОРТАНІ
Ольховський В.О., Губін М.В., Григорян Е.К.
Постраждалі з нелетальними травмами гортані, стають об'єктом судово-медичної оцінки тяжкості тілесних ушкоджень у живих осіб, яка проводиться під час досудового та судового слідства. Мета роботи: морфо-клінічний аналіз та характеристика тілесних ушкоджень при тупій травмі гортані, під час судово-медичної експертизи живих осіб для визначення шляхів підвищення ефективності судово-медичної діагностики зазначеної травми. Суб'єкт і методи. Проведено морфо-клінічний аналіз 47 висновків експерта провідної судово-медичної експертної установи Харківського регіону. Результати дослідження. Визначено частоту і типи тупої травми гортані при експертизі живих осіб. Встановлено особливості судово-медичної експертизи при визначенні ступеня тяжкості тілесних ушкоджень у живих осіб з тупою травмою гортані. Тяжкі тілесні ушкодження встановлені експертами в 3 випадках (6,4% спостережень) травм гортані з розвитком механічної асфіксії. Ушкодження середньої тяжкості встановлені експертами в 9 випадках (19,1% спостережень) тупих травм гортані, що супроводжувалися переломами її хрящів; у 4 випадках (8,5% спостережень), що супроводжувались гематомою, набряком м'яких тканин гортані; в одному випадку тупої травми гортані з гострим набряком, її стенозом II ступеня. Легкі тілесні ушкодження, що спричинили короткочасний розлад здоров'я в 25 випадках (53,2% спостережень ) та що викликали незначні транзиторні ефекти в 4 випадках (21,1% спостережень) встановлені експертами при експертизі тупих травм гортані з розвитком гострих посттравматичних ларингітів. Визначено шляхи та алгоритм вдосконалення судово-медичної експертної діагностики цієї травми. Висновки. При судово-медичній діагностиці тупої травми гортані, мають місце випадки недооцінки та переоцінки тяжкості тілесних ушкоджень експертами, що вимагає проведення подальших наукових досліджень у напрямку встановлення чітких експертних діагностичних критеріїв оцінки таких травм.
Ключові слова: критерії діагностики, судово-медична експертиза, висновок експерта, травми гортані.
Резюме.
СУДЕБНО-МЕДИЦИНСКАЯ ЭКСПЕРТИЗА В СЛУЧАЯХ НЕЛЕТАЛЬНИХ ТРАВМ ГОРТАНИ
Ольховский В.А., Губин Н.В., Григорян Е.К.
Пострадавшие с нелетальными травмами гортани, становятся объектом судебно-медицинской оценки тяжести телесных повреждений у живых лиц, которая проводится в ходе досудебного и судебного следствия. Цель работы: морфо-клинический анализ и характеристика телесных повреждений при тупой травме гортани, во время судебно-медицинской экспертизы живых лиц для определения путей повышения эффективности судебно-медицинской диагностики указанной травмы. Субъект и методы. Проведен морфо-клинический анализ 47 заключений экспертов ведущего судебно-медицинского экспертного учреждения Харьковского региона. Результати исследования. Определены частота и виды тупой травмы гортани при экспертизе живых лиц. Установлены особенности судебно-медицинской экспертизы при определении степени тяжести телесных повреждений у живых лиц с тупыми травмами гортани. Тяжкие телесные повреждения установлены экспертами в 3 случаях (6,4% наблюдений) травм гортани с развитием механической асфиксии. Повреждения средней тяжести установлены экспертами в 9 случаях (19,1% наблюдений) тупых травм гортани, сопровождавшихся переломами ее хрящей; в 4 случаях (8,5% наблюдений), сопровождавшихся гематомой, отеком мягких тканей гортани; в одном случае тупой травмы гортани с острым ее отеком, стенозом II степени. Легкие телесные повреждения, повлекшие кратковременное расстройство здоровья в 25 случаях (53,2% наблюдений) и которые вызвали незначительные транзиторные эффекты в 4 случаях (21,1% наблюдений) установлены экспертами при экспертизе тупых травм гортани с развитием острых посттравматических ларингитов. Определены пути и алгоритм совершенствования судебно-медицинской экспертизы данной травмы. Выводы. При судебно-медицинской диагностике тупой травмы гортани, имеют место случаи недооценки и переоценки тяжести телесных повреждений экспертами, что требует проведения дальнейших научных исследований в направлении установления четких экспертных диагностических критериев оценки таких травм.
Ключевые слова: критерии диагностики, судебно-медицинская экспертиза, заключение эксперта, травмы гортани.
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