目的探讨新生儿死亡医疗纠纷中临床及法医病理学特点,启示儿科医护人员在防范此类医疗纠纷时应注意的相关问题。方法对四川大学华西基础医学与法医学院法医病理教研室1998年1月-2007年12月的60例新生儿死亡尸检案例进行回顾性统计分析。结果 60例中除3例非正常死亡外,57例为自然性疾病死亡。其中出生后24h死亡32例(56.1%),死亡男婴40例(70.2%)。死亡原因主要为胎粪吸入综合征、肺透明膜病、肺出血等窒息性疾病(49.1%)。其中医疗过失性纠纷21例(36.8%),医疗过失的原因主要为观察不仔细、处理不及时、误诊漏诊、产前检查或助产处理不当、告知不足等。涉及纠纷的医院以市级医院居多(58.7%)。结论医护人员应严格遵守诊疗常规和操作规范,对新生儿加强监护,及时抢救,同时应积极与家属沟通,以减少医疗纠纷的发生。 Objective To explore the clinical and forensic pathological features of neonatal death medical disputes and to reveal the relevant issues that should be noticed by pediatric medical staff in preventing such medical disputes. Methods A retrospective statistical analysis of 60 neonatal death autopsy cases from January 1998 to December 2007 in Department of Forensic Pathology, West China School of Preclinical and Forensic Medicine, Sichuan University was conducted. Results Of the 60 cases, 3 cases were not normal death, 57 cases of natural disease death. Among them, 32 (56.1%) died after birth and 40 (70.2%) died. The main causes of death were meconium aspiration syndrome, hyaline membrane disease, pulmonary hemorrhage and other asphyxia diseases (49.1%). Among them, 21 cases (36.8%) were involved in the dispute of medical negligence. The main reasons of medical negligence were not careful observation, improper treatment, misdiagnosis and missed diagnosis, improper prenatal examination or midwifery treatment, inadequate notification and so on. The majority of hospitals involved in disputes are municipal hospitals (58.7%). Conclusion Medical staff should strictly abide by the routine and practice of diagnosis and treatment, strengthen guardianship and rescue in time, and should actively communicate with family members to reduce the occurrence of medical disputes.