颅脑损伤所致轻度智力缺损和边缘智力司法精神病学鉴定的对照分析

Comparative analysis of mild mental impairment caused by craniocerebral injury and marginal intelli-gence forensic psychiatric evaluation

目的:探讨交通事故中颅脑损伤所致轻度智力缺损和边缘智力司法鉴定的特点。方法:对236例交通事故司法鉴定中轻度智力缺损(轻度组)68例和边缘智力(边缘组)168例患者的鉴定资料进行分析,所有案例鉴定时均作头颅CT及脑电图检查。结果:轻度组有88.2%(60/68例)、边缘组有20.2%(34/168例)的患者为中重度以上颅脑损伤(χ2=100.2,P<0.01)。轻度组脑外伤后格拉斯哥昏迷量表评分(t=14.1)、昏迷时间(t=4.6)及头颅CT结论(χ2=80.7)均明显重于边缘组(P均<0.01)。轻度组有14.7%(10/68例)、边缘组有36.9%(62/168例)的患者智商检查和鉴定结论不一致。轻度组鉴定时的头颅CT软化灶(χ2=41.5)、脑电图异常(χ2=76.9)均多于边缘组(P均<0.01)。结论:轻度智力缺损较边缘智力患者颅脑损伤程度重,头颅CT软化灶及异常脑电图改变多,智商低。

Objective： This study aims to investigate the characteristics of mild mental impairment due to craniocerebral injury caused by traffic accident and marginal intelligence forensic evaluation. Method：Pa- tient data in 236 cases of traffic accidents, assessed by forensic evaluation into mild mental impairment （ mild group, 68 cases） and marginal intelligence group （marginal group, 168 cases）were evaluated. Results： 88.2% of the mild group （60/68） in severe craniocerebral injury,and 20.2% of the border group （（34/168） （ X2 = 100.2 ,P 〈0.01 ）. The score of Glasgow coma scale score after craniocerebral injury（ t = 14.1 ） ,coma du- ration （t = 4.6）and cranial CT（ X2 = 80.7）in mild group were heavier than the border group （all P 〈 0.01 ）. The score of IQ and identification were inconsistent, which were 14.7% （ 10/68 ） of the mild group and 36.9% （62/168） of the border group. The mild group in the evaluation of cranial CT malacia （ x2 = 41.5） and EEG abnormalities（x2 =76.9）were heavier than the border one（all P〈0.01）. Conclusion： Compared with the border one, the mild mental impairment people have heavier craniocerebral injury, more head CT softening and abnormal EEG chan,,es and lower IO score.