152例道路交通事故致儿童眼损伤的法医学分析

目的:探讨道路交通事故致儿童眼损伤的类型、损伤特点、主要并发症及其伤残等级分布的特点,为此类案件的法医临床学鉴定提供参考。方法:对152例道路交通事故致儿童眼损伤的伤残评定资料按伤者受伤的临床诊断分类、有无并发症、并发症的类型及伤残程度进行统计分析。结果:1~3岁的儿童因交通事故致眼外伤构成比较低,4~6岁明显上升,11~14岁最高。大部分眼外伤为单眼损伤,眼部钝挫伤129眼,眼球穿通伤21眼,混合型眼部伤20眼,眼部烧伤2眼。主要并发症及后遗症为外伤性白内障53眼(30.8%)、外伤性青光眼18眼(10.5%)、外伤性视网膜脱离14眼(8.1%)、外伤性眼内炎9眼(5.2%)。结论:眼部钝挫伤在道路交通事故致儿童眼损伤中多见,并发症多预后差,鉴定难度较成人增大。针对学龄前和学龄期儿童因道路交通事故致眼损伤的伤残评定应适当放宽标准,伤残评定标准应增加专门针对儿童的条款。

Forensic analysis of 152 cases of children with ocular injury in road traffic accidents

Objective:To study the types,characteristics and common complications as well as disability assessment for the children with ocular injury in the road traffic accidentsand to provide reference for forensic clinical evaluation of such cases.Methods:Data of 152 cases of children with ocular injury in road traffic accidents were collected and statistically analyzed according to the clinical diagnostic classification of injuries,complication,the type of complication and the severity of disability.Results:Children aged 1 to 3 were less likely to have an eye injury due to traffic accidents,eye injuries of 4 to 6 years old children increases obviously,the highest injuries rate was in 11 to 14 years oldchildren.Most ocular injuries happened to single eye.There were 129 cases of ocular blunt injury,21 cases of perforating injury of eyeball,20 cases of mixed eye injury and 2 cases of eye burns.The main complications included traumatic cataract(53,30.8％),traumatic glaucoma (18,10.5％),traumatic retinal detachment(14,8.1％) and traumatic ophthalmitis (9,5.2％).Conclusion:Among the children with ocular injury due to road traffic accidents,ocular blunt injury are the most common result,have more complications and poor prognosis,so it is more difficult to identify than adults.The assessment criteria for body impairment of the children with ocular injury in the road traffic accidents should be broadened accordingly,with addition of certain specific items for children.