法医学杂志

法医学杂志 ›› 2013, Vol. 29 ›› Issue (2): 116-119.DOI: 10.3969/j.issn.1004-5619.2013.02.009

• 案例分析 • 上一篇    下一篇

534例脑外伤所致精神障碍的司法精神病鉴定分析

李  婷，李国荣，江红霞，汤晨东，唐建良   

  1. （嘉兴市康慈医院司法鉴定室，浙江 嘉兴 314500）
  • 发布日期:2013-04-25 出版日期:2013-04-28
  • 作者简介:李婷（1977—），女，山东德州人，硕士，主治医师，主要从事精神病的临床、科研及司法鉴定工作；E-mail：liting406@ yahoo.com.cn
  • 基金资助:

    浙江省医学会临床科研基金资助项目（2011ZYC-A06）

Forensic Psychiatric Cases of 534 Mental Disorders Caused by Traumatic Brain Injury

LI TING, LI GUO-RONG, JIANG HONG-XIA, TANG CHEN-DONG, TANG JIAN-LIANG   

  1. （Department of Forensic Medicine, Kangci Hospital of Jiaxing, Jiaxing 314500, China）
  • Online:2013-04-25 Published:2013-04-28

被引次数

15

摘要： 目的 分析脑外伤所致精神障碍的类型及鉴定的合理时间，探讨脑损伤程度及鉴定时间与智能损害程度的关系。 方法 对534例脑外伤患者的司法精神病鉴定资料进行回顾性分析。 结果 脑外伤所致精神障碍的类型中，器质性情感障碍最多（51.1%），其次为器质性神经症样综合征（24.0%）、器质性智能损害（18.0%）。伤残程度鉴定为Ⅷ级和Ⅸ级伤残最多，分别为219例（41.0%）和177例（33.1%）。智能损害组的脑损害程度、中国修订版韦氏成人智力量表（WAIS-RC）评定智力缺损程度明显高于非智能损害组（P<0.05）。伤残等级和脑损伤分级、WAIS-RC评定结果、鉴定时的脑CT变化以及脑电地形图（brain electrical activity mapping，BEAM）异常分级具有相关性（P<0.05），而智能损害程度与鉴定时间及脑损伤分级均无相关性（P>0.05）。 结论 影响智能损害的因素很复杂，伤残程度鉴定时脑CT、BEAM、WAIS-RC等客观检查也是重要的参考指标。

关键词: 司法精神病学, 脑损伤, 精神障碍

Abstract: Objective To analyze the types of mental disorders caused by traumatic brain injury and the optimal time for forensic psychiatric appraisal. To explore the relationship between the degree of traumatic brain injury, the time of appraisal and the grade of intellectual deficiency. Methods Five hundred and thirty-four forensic psychiatric cases of mental disorders caused by traumatic brain injury were retrospectively analyzed. Results In the types of mental disorders caused by traumatic brain injury, the most cases were diagnosed as organic mood disorders （51.1%）, following organic neurosis-like syndrome （24.0%） and organic intellectual deficiency （18.0%）. For the disability grades, the most cases were the level Ⅷ and Ⅸ disability grades, 219 cases （41.0%） and 177 cases （33.1%）, respectively. The degree of brain injury and the degree of intelligence defection according to WAIS-RC were higher in intellectual deficiency group compared with non-intellectual deficiency group （P<0.05）. The grade of disability correlated with the degree of brain injury, the result of WAIS-RC, the result of cerebral CT scanning, and the grade of brain electrical activity mapping （BEAM） abnormality （P<0.05）. Nevertheless, the degree of intellectual deficiency did not correlate with appraisal time and the degree of brain injury （P>0.05）. Conclusion The factors influencing intellectual deficiency are complex. The findings of objective examination including cerebral CT scanning, BEAM, WAIS-RC and others should be considered as important indexes for disability evaluation.

Key words: forensic psychiatry, brain injuries, mental disorders

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