胸背部外伤致持续性植物状态案例分析

Persistent Vegetative State Caused by Non-brain Damage and Its Forensic Assessment

在现有的法医学文献中,多将持续性植物状态(persistentvegetativestate,PVS)作为颅脑损伤的并发症进行介绍。但在法医学鉴定实践中,非颅脑损伤所致的PVS并非少见。另一方面,目前通用的法医学鉴定标准中,只有《道路交通事故受伤人员评定》将PVS明确列为评残条文,并归入"颅脑、脊髓及周围神经损伤致"项内。由于上述两方面原因,PVS、特别是非颅脑损伤所致PVS的损伤程度、伤残等级的评定均成为鉴定难点。在实际检案中,可以结合PVS的病因和病理机制、临床表现及法医学检查特点加以综合分析,进而作出损伤程度、伤残等级的评定。

Persistent vegetative state （PVS） is described as one of the complications of brain damage in the current forensic science literatures. PVS unrelated to brain damage, however, is not uncommon in daily forensic practice. Currently, only ＂Assessment for Body Impairment of the Injured in Road Traffic Accident＂ designates PVS as one of its items under the section of ＂Brain, Spinal Cord, and Nerves Injury.＂ Therefore, it is difficult to assess the damage and disability in PVS, especially PVS due to non-brain damage. Based on a case of PVS caused by chest injury in combination with relevant literature review, this paper provides a summary on the general information, etiology, pathogenesis, clinical manifestation, diagnosis and differential diagnosis of PVS, as well as a guideline for its forensic assessment.