脑外伤所致精神障碍患者鉴定资料分析

目的 探讨交通事故中脑外伤所致精神障碍患者的临床特征,为伤残鉴定提供依据.方法 对因交通事故造成的130例脑外伤所致精神障碍患者的鉴定资料进行回顾性分析.结果 脑外伤所致各种精神障碍的发生率依次为:智能损害73.85%、神经症样综合征24.62%、精神病性症状17.69%、人格改变10.77%、遗忘4.62%、情感障碍3.08%;46.88%智能损害合并其他精神障碍症状,智能障碍等级以轻度智能损害(47.92%)为主,颅内血肿、脑干损伤、脑损伤范围、格拉斯哥分度量表评分、合并其他精神障碍和文化程度是脑外伤所致智能损伤程度的影响因素;精神病性症状与脑干损伤、脑损伤范围、颅内血肿有密切关系;人格改变与额叶损伤、颅内血肿及开颅治疗有关.结论 交通事故中,脑外伤所致精神障碍以轻度智能损害为主,与颅内血肿、脑干损伤、脑损伤范围、损伤部位等有关,其鉴定工作应结合颅脑创伤情况,应用检测工具全面评估其精神状态.

Analyses of identification data of mental disorders due to brain trauma

Objective To explore the clinical features of mental disorders due to brain trauma caused by traffic accident in order to provide basis for disability appraisal. Methods Retrospective analyses of 130 case identification data of mental disorders due to brain trauma. Results The incidence of mental disorders due to brain trauma was in turn that intellectual impairment made up 73. 85%, neurosis like syndrome 24.62%, psychotic symptoms 17.69%, personality change 10.77%, amnesia 4.62% and affective disorder 3.08% ; 46.88% of intellectual impairment with the symptoms of other mental disorders, disturbance of intelligence was mainly mild （47.92%）, and factors influencing intellectual impairment severity were in tracranial hematoma, brain stem injury, brain lesion dimensions, Glasgow Coma Scale score, combined other mental disorders and educational level; mental symptoms were closely related to brain stem injury, brain lesion dimensions and intracranial hematoma; personality changes were related to frontal lobe injure, intracranial hcmatoma and opening cranium treatment. Conclusion Mental disorder due to brain trauma caused by traffic accidents is mainly mild intellectual impairment, is related to intracranial hcmatoma, brain-stem injury, brain lesion dimensions and damage location, their mental states should be comprehen sively assessed using detection instrument and combining with craniocerebral trauma condition.