胸腰椎爆裂型骨折的法医赔偿学研究  

Study on Forensic Compensation Medicine for Burst Fracture of Lumbar and Thoracic Vertebrae

作　　者：李生彦[1] 黄思兴[2] 彭继恒[3] 孔斌[1] 刘宽林[1] 

机构地区：[1]南充市公安局交警支队川北医学院法医学系,四川南充637000 [2]成都市公安局交通管理局,四川成都610036 [3]长沙市公安局刑侦支队,湖南长沙察410000

出　　处：《川北医学院学报》2005年第4期434-436,共3页Journal of North Sichuan Medical College

摘　　要：目的探讨车祸致胸腰椎爆裂型骨折伤者的赔偿医学问题。方法从5869件伤残评定案例中选择胸腰椎爆裂型骨折126例进行统计分析。结果胸腰椎爆裂型骨折临床漏诊、误诊率高,X线平片对此准确诊断缺乏敏感度和特异度;MR I对附件骨折的诊断不及CT;CT对骨髓、韧带及软组织损伤的诊断准确率不及MR I,爆裂型骨折多发生在T11-L2段,单一椎体与两个及其以上椎体损伤的伤残等级的分布上无显著性差异。结论对胸腰椎爆裂型骨折的诊断,X线平片是基础,CT检查应列为常规,MR I是必要的补充,相互印证;《道路交通事故受伤人员伤残评定》标准相关条款中的“椎体粉碎性骨折”这个提法不是规范的诊断术语,值得商榷。Objective To discuss the treatment of compensation medicine for the injured on burst fracture of lumbar and thoracic vertebrae caused by traffic accident. Methods Statistical analysis has been done for 126 cases with burst fracture of lumbar and thoracic vertebrae who had been selected from 5869 cases of gradation of disability. Results Misdiagnosis is common on burst fracture of lumbar and thoracic vertebrae because of the low sensitivity and specificity of x-ray photograph ; MRI is superior to CT for the diagnosis of fracture , but inferior to CT for that of spinal cord, ligament and soft tissue injury; burst fracture often occurs at T1-L2 . There is not significant difference on disability scale between one and more cones. Conclusion For the diagnosis of burst fracture , x-ray photograph is the basis, CT should be regarded as a routine examination and MRI is supplementary if necessary.

关 键 词：胸腰椎 爆裂型骨折 法医学鉴定 赔偿医学 

分 类 号：D919[医药卫生—法医学]