從司法解剖看學齡前兒童死亡案件之統計與分析

Analysis in Pre-school Child Mortality Cases via Forensic Autopsy in Taiwan

楊惠婷(Yang Hui-Ting)

指導教授 ： 孫家棟

國立臺灣大學/醫學院/法醫學研究所/碩士(2011年)

https://doi.org/10.6342/NTU.2011.02525

摘要

研究目的：本研究欲藉由司法解剖之兒童死亡案例分析其死亡方式及死亡原因，統計並比較相關的傷害型態，進而與國內外相關文獻比較，以期能提供關於臺灣本土兒童死亡案件更多的資訊。研究結果：本研究共收集394例六歲以下兒童司法解剖案例，自然死案例佔53.55%，意外死亡案例佔23.35%，他殺案例佔16.5%，未確認案例佔6.6%。男女性別比，除他殺案例以女童為多，意外死、自然死案例皆以男童為多。一歲以下嬰兒主要死亡原因依序為(1)意外事故，(2)肺炎，(3)嬰兒猝死症候群，而1~6歲主要死亡原因依序為(1)他殺，(2)意外事故，(3)肺炎。自然死案例死亡原因依序為(1)感染，尤以肺炎感染居多，(2)嬰兒猝死症候群，(3)生產相關併發症。意外死案例死亡原因依序為(1)窒息，以一歲以下嬰兒溢奶及異物阻塞氣管居多，(2)跌落，(3)生產意外。他殺案例死亡原因依序為(1)鈍性傷害，年齡愈小者，致命傷在頭部的機率愈高，且身體各部位傷害數量較意外死及自然死案例多出許多，成對捏傷、咬痕型態傷及會陰部紅腫傷害，為他殺案件所特有，(2)窒息，(3)中毒，可見我國主要的兒童虐待致死種類為身體虐待。各死亡方式中，以他殺案例的母親生產年齡為最低 (24.75歲)。施虐者主要以女性為主，且孩童父母及關係人有精神疾病及不良前科的比例較其他死亡方式高，值得社福單位的重視。綜合結論：由於本研究僅收集司法解剖案例，故在死亡原因的統計上與行政院衛生署的官方統計資料不盡相同，呈現出司法解剖族群資料統計上的偏差；因此建議提高本國兒童的司法解剖率，讓死亡方式及死亡原因統計更全面性，進而能發展相關的兒童保護政策，讓兒童能夠有更健康、安全的成長環境。

關鍵字

學齡前兒童 ； 司法解剖 ； 死亡方式 ； 死亡原因 ； 兒童虐待

並列摘要

Objective: The purpose of this study was to analyze manner and cause of death in children under six years old by forensic autopsy cases and compare related injury patterns, aiming to provide more information about children’s death.
Results: We collected 394 cases of children under six: 53.55% cases died of natural death, 23.35% cases died of accidental death, 16.5% cases died of homicide death, and 6.6% cases died of undetermined death. There were more girls than boys in homicidal cases. In more details, the three main cause of death in infants are (1) accidents, (2) pneumonia and (3) sudden infant death syndrome, and in 1~6 years old children are (1) homicides, (2) accidents and (3) pneumonia. Subanalysis the etiology in the three main manner of death in the group under six years old. The main etiology in natural death are (1) infection, mainly pneumonia, (2) sudden infant death syndrome and (3) birth-related complications ; in accidental death are (1) asphyxia, particularly in infants ( regurgitation or aspiration of foreign body in trachea), (2) falls and (3) birth accidents; and in homicide are (1) blunt injury, the younger children have the higher probabilities of fatal head injuries, and the distribution of body injuries are obviously higher than accident and natural death, especially paired pinching injury, bite marks and perineum injuries are specific for homicidal cases, (2) asphyxia and (3) poisoning. It showed that main type of child fatal abuse in Taiwan is physical abuse. In the homicide cases,
maternal age is more in young (24.75 years old) and abusers are female-dominated. The proportions of mental illness, criminal records of parents or related people are the highest compared to other forms of manner of death. It’s worth social welfare institutions paying close attention to this situation.
Conclusions: Because this study only analyzes forensic autopsy cases, there was selected bias compared to other researches. This study gives us a hint that promotes children’s forensic autopsy rate which will give more close relationship to the official epidemiological data. Then we can develop more appropriate children protection policies to promote our children to have a more healthy and safe milieu for growth.

並列關鍵字

Preschool Children ； Forensic Autopsy ； Cause of Death ； Manner of Death ； Child Abuse

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