颅脑外伤致运动和感觉障碍的评残时机

发布时间：2019-02-11 09:50

【摘要】：目的研究颅脑外伤致运动、感觉障碍相对合理准确的最佳鉴定时机。方法分别收集108例交通事故颅脑外伤患者伤后不同时间段(3、6、9、12、15、18月)的病史、影像学及电生理检查资料,并对患者家属进行随访调查,进行法医学检验,据此做出诊断并进行伤残等级评定;同时分别应用脑卒中残损评价表(Stroke Impairment Assessment Set,SIAS)、日常生活能力量表(Activity of Daily Living Scale,ADL)和Fugl-Meyer评定表(Fugl-Meyer assessment,FMA)对患者进行测验。结果SIAS、ADL、FMA对不同等级伤残及不同时间段区分良好,整体样本显示患者SIAS、ADL、FMA平均值9月至18月变化无差别,轻度伤残SIAS、ADL、FMA平均值6月至18月变化无差别,中度伤残SIAS、ADL、FMA平均值9月至18月变化无差别,重度伤残SIAS、ADL、FMA平均值12月至18月变化无差别。结论颅脑外伤所致运动、感觉障碍评残时机应在医疗终结以后,轻度伤残(7～10级)最佳评残时机为颅脑外伤后6个月,中度伤残(4～6级)评残时机以颅脑外伤后9个月为宜,重度伤残(1～3级)评残时机不应短于伤后12个月,视具体情况可以适当延后评残。
[Abstract]:Objective to study the best time to identify motor and sensory disorders caused by craniocerebral trauma. Methods the history, imaging and electrophysiological data of 108 patients with traffic accident craniocerebral trauma were collected at different time periods (3X, 91215months, 18months). The family members of the patients were followed up and examined by forensic medicine. The diagnosis is made and the disability grade is assessed accordingly; At the same time, the patients were tested with (Stroke Impairment Assessment Set,SIAS, (Activity of Daily Living Scale,ADL and Fugl-Meyer assessment,FMA respectively. Results SIAS,ADL,FMA showed that there was no difference in the mean value of SIAS,ADL,FMA between September and 18 months, but there was no difference in the mean value of SIAS,ADL,FMA between June and 18 months in patients with mild disability. There was no difference in the mean value of SIAS,ADL,FMA between September and 18, but there was no difference in the mean value of SIAS,ADL,FMA between December and 18 in severe disability. Conclusion the best time for evaluating disability due to craniocerebral injury should be 6 months after the end of medical treatment, and the best time for mild disability (7 ~ 10 grade) should be 6 months after craniocerebral injury. 9 months after craniocerebral injury was the best time to evaluate the disability of moderate disability (grade 4 ~ 6), and the time of evaluation of severe disability (grade 1 ~ 3) should not be shorter than that of 12 months after injury, depending on the specific situation, the evaluation of disability could be postponed appropriately.
【作者单位】：常州市德安医院司法鉴定所;
【分类号】：D919.4

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