Russian Journal of Forensic MedicineRussian Journal of Forensic MedicineСудебная медицина2411-87292409-4161Eco-Vector1611310.17816/fm16113Systematic reviewsСистематические обзоры系统回顾Review ArticlePostmortem characteristics of drowning death in freshwater: a systematic reviewПосмертная характеристика случаев утопления в пресной воде: систематический обзор淡水溺水的尸检特征：系统综述https://orcid.org/0009-0002-8926-1233AflanieIwan
Indonesia

MD, PhD, Department of Forensic and Medicolegal, Medical School

iwanaflanie73@gmail.comhttps://orcid.org/0000-0003-1921-3172SuhartoGusti Muhammad Fuad
Indonesia

MD, Department of Forensic and Medicolegal, Medical School

suhartogete@gmail.comhttps://orcid.org/0000-0002-1024-5488NurikhwanPandji Winata
Indonesia

MD, Department of Medical Education, Medical School

pandji.winata@ulm.ac.idUniversitas Lambung Mangkurat07062024310720241022202281701202422042024Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-ВекторCopyright ©; 2024,2024Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0/https://for-medex.ru/jour/article/view/16113

BACKGROUND: Drowning is the third leading cause of death by unintentional injury, accounting for 7% of all injury-related deaths worldwide. According to the latest World Health Organization Global Health Estimates, 236,000 people died from drowning in 2019.

AIM: This systematic review aimed to examine the clinical, laboratory, and other postmortem characteristics associated with death from drowning in freshwater areas.

MATERIALS AND METHODS: A systematic search of PubMed, Epistemonikos, and Cochrane Library databases was performed with no restrictions to find relevant articles. After the removal of duplicates, articles were reviewed, and information on the clinical, laboratory, and other postmortem characteristics of freshwater drowning deaths was extracted.

RESULTS: Of the 493 articles, 73 papers were considered relevant for full-text review. Of these, 22 articles met the inclusion criteria for the review. Most drowning deaths occurred in freshwater. Victims were males, with a male-to-female ratio of 8:3. External and internal clinical characteristics that are widely reported included signs of asphyxia such as cyanosis of the lips and bilateral fingernails, immersion signs such as washerwoman’s hand, pink teeth, Neil’s sign, Svechnikov’s sign, Wydler’s sign, and debris in the airways, and typical drowning signs such as froth in the airway, emphysema aquosum, and Paltauf spot.

CONCLUSION: The results of this study suggest that the presence of signs of asphyxia, immersion signs, and typical drowning signs such as froth in the airway, emphysema aquosum, and Paltauf spots were associated with drowning deaths in freshwater.

Обоснование. Утопление ― третья основная причина смертности от непреднамеренных травм, что составляет 7% всех смертей в мире, связанных с травмами. Согласно последним глобальным оценкам Всемирной организации здравоохранения, в 2019 году от утопления умерло 236 000 человек.

Цель исследования ― изучить клинические, лабораторные и другие посмертные характеристики, связанные со смертью от утопления в пресной воде.

Материалы и методы. Систематический поиск релевантных статей проводился без каких-либо ограничений в базах данных PubMed, Epistemonikos и Cochrane Library. После удаления дубликатов выполнен анализ статей с извлечением информации о клинических, лабораторных и других посмертных характеристиках случаев утопления в пресной воде.

Результаты. Из 493 статей признаны релевантными для полнотекстового обзора 73, из них 22 статьи отвечали критериям включения в исследование. В большинстве случаев смерть от утопления наступала в пресной воде. Среди жертв преобладали мужчины (соотношение мужчин и женщин 8:3). К хорошо известным внешним и внутренним признакам утопления относятся асфиксия (синюшность губ и ногтей), признаки погружения тела в воду («рука прачки», «розовые зубы»), признаки Нила, Свешникова и Уайдлера, инородные вещества в дыхательных путях, а также типичные признаки утопления, такие как пена в дыхательных путях, emphysema aquosum (так называемая водяная эмфизема) и пятна Пальтауфа.

Заключение. Наличие признаков асфиксии, погружения в воду и утопления (пена в дыхательных путях, emphysema aquosum, пятна Пальтауфа) свидетельствуют о гибели утопающих в пресной воде.

论证。溺水是意外伤害导致死亡的第三大原因，占全球所有与伤害相关死亡人数的 7%。根据世界卫生组织最新的全球估计，2019 年有 23.6 万人死于溺水。

研究目的是调查与淡水溺水死亡相关的临床、实验室和其他尸检特征。

材料和方法。在 PubMed、Epistemonikos 和 Cochrane Library 数据库中对相关文章进行了无限制的系统搜索。在删除重复文章后，对文章进行了分析，提取有关淡水溺水病例的临床、实验室和其他尸检特征的信息。

结果。在 493 篇文章中，发现有 73 篇与全文综述相关，其中 22 篇符合研究的纳入标准。大多数溺水死亡事件发生在淡水中。受害者中男性居多（男女比例为 8:3）。众所周知的溺水外部和内部征兆包括窒息（嘴唇和指甲发青）、身体浸泡在水中的征兆（"洗衣手"、 "粉色牙齿"）、Neil、Sveshnikov 和 Wyidler 征兆、呼吸道异物以及典型的溺水征兆，如呼吸道泡沫、aquosum 肺气肿（所谓的水气肿）和 Palthauf 斑。

结论。出现窒息、浸水和溺水征兆（呼吸道泡沫、肺气肿、Palthauf 斑）表明是在淡水中溺水死亡。

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