颅脑损伤伤残等级评定的影响因素

Influencing factors of disability grade assessment of traumatic brain injury

目的 探讨道路交通事故颅脑损伤伤残等级评定的影响因素。方法 采用自编调查表收 集2014年1~12月在华西法医鉴定中心进行伤残评定的道路交通事故所致颅脑损伤患者的相关资料。研 究对象182例（70.27%）完成了韦氏智力测验（WAIS），作为有IQ值组；77例（29.73%）患者未完成WAIS智力 测验，作为无IQ值组。分别对其社会-人口学特征、颅脑损伤的相关特征和伤残等级进行分析。根据伤 残等级评定结果，将被鉴定者分为4组，分析其损伤特征的差异。结果 共纳入259例颅脑损伤患者进行 司法鉴定，有IQ值组和无IQ值组被鉴定者性别、年龄、居住地、职业和文化程度比较，差异无统计学意义 （P＞ 0.05）。不同伤残等级被鉴定者住院时间、GCS评分、昏迷时间、脑电图特征比较，差异有统计学意义 （P＜0.05）。Spearman相关性分析显示，GCS评分、昏迷时间、脑电图特征、住院时间和伤残等级间有相关性 （P＜ 0.05）。结论 伤残等级的评定与住院时间、GCS评分、昏迷时间和脑电图的异常程度有关。

Objective To explore the influencing factors of the disability grade assessment of traumatic brain injury in road traffic accidents. Methods A self-made questionnaire was used to collect related information of patients with traumatic brain injury caused by road traffic accidents, who underwent disability assessment in West China Center of Forensic Medicine Services from January to December 2014. A total of 182 cases（ 70.27%） of all research objects who had completed the Wechsler Adult Intelligence Scale（ WAIS） were allocated to IQ value group, and 77 cases（ 29.73%） who had not completed WAIS were allocated to non-IQ value group. Social demographic characteristics, traumatic brain injury related characteristics and the level of disability were analyzed. According to the result of disability grade assessment, research objects were divided into 4 groups to analyze the difference of injury characteristics. Results A total of 259 cases of traumatic brain injury patients underwent judicial identification. There was no statistical difference in demographic data between the two groups（ including gender, age, place of residence, occupation and education background）（ P〉 0.05）. However the differences in hospitalization time, Glasgow Coma Scale（ GCS） score, coma time and electroencephalogram（ EEG） characteristics of the patients of different disability grades were statistically significant（ P〈0.05）. Spearman correlation analysis showed that there was a correlation between GCS score, coma time, EEG characteristics, hospitalization time and disability level（ P〈0.05）. Conclusions The assessment of disability grade is correlated with hospitalization time, GCS score, coma time, and the abnormal degree of EEG.