颅脑损伤所致精神障碍的司法精神医学鉴定分析

Fornsic psychiatric appraisal of 85 cases with mental disorders due to brain injury

目的探讨颅脑损伤所致精神障碍类型,以及颅脑受损程度、范围及鉴定时间与智力障碍程度的关系。方法对85例颅脑损伤患者的司法精神医学鉴定资料进行回顾性分析。结果85例颅脑损伤所致精神障碍中,以智力障碍为首位,共70例(82.4%);伤残等级评定为Ⅶ-X级共81例(95.3%);智力障碍程度与损伤时间及鉴定时间无相关性(χ2=0.53,P>0.05),但与脑损伤的程度有相关性(P<0.05);有智力障碍组脑干损伤(30.0%)、脑内血肿(29.1%)的比例高于无智力障碍组(分别为20.0%和13.3%;P<0.01),≥2个脑叶损伤的比例(62.5%)高于无智力障碍组(36.4%,P<0.05)。结论颅脑损伤所致智力障碍占第一位,颅脑损伤程度与智力障碍有明显相关性,伤残等级以Ⅶ-X级为高。

Objective To explore the types of mental disorders due to brain injury and the relationship between the severity of brain injury, duration and intelligence. Methods The authenticate records of 85 cases with brain injury was reviewed. Results The disabality degrees of 81 cases （95. 3% of 85） were rated between grade 7 to 10. The intelligence impairment was correlated to the severity of brain injury, and no association between intelligence impairment and duration was found. In subjects with intelligence impairment,the rates of having brain stem injury,intracerebrat hematoma, and ≥2 lobes injuries were higher than ones without intelligence impairment（ P 〈 0. 01 ）. Concluslon The intelligemce impairment is the most common disorder in the subjects with brain injury. It＇ s necessary to establish duration criteria for diagnostis of mental disorders due to brain injury.