眼球钝挫伤后视网膜脱离的司法鉴定  

Forensic Medical Assessment in Post-trauma Retinal Detachment

作　　者：刘瑞珏[1] 夏文涛[1] 范利华[1] 

机构地区：[1]司法部司法鉴定科学技术研究所,上海200063

出　　处：《法医学杂志》2007年第4期261-264,268,共5页Journal of Forensic Medicine

摘　　要：目的分析眼球钝挫伤后视网膜脱离在法医临床学眼损伤及伤残鉴定中的致伤原因及因果关系。方法研究112例眼球钝挫伤后视网膜脱离案例,对其中视网膜裂孔类型、外伤至视网膜脱离时间、合并其他损伤或疾病进行分析。结果本组案例锯齿缘离断4.28%,黄斑裂孔12.50%,其他部位的裂孔(<90°)56.25%,巨大裂孔(>90°)5.00%,未发现裂孔的增殖性玻璃体视网膜病变(PVR)性视网膜脱离11.6%,其中45眼有不同程度的PVR。外伤至视网膜脱离的时间以1周～2个月为常见(61.60%)。合并中高度近视者83.93%,合并玻璃体混浊者52.68%。外伤与视网膜脱离存在直接因果关系者41.07%,存在间接因果关系者52.68%,外伤与视网膜脱离难以联系者6.25%。结论视网膜脱离与多种危险因素有关,外伤与视网膜脱离之间因果关系的分析是法医学眼损伤及伤残鉴定的重要内容。Objective To analyze risk factors associated with post-traumatic identify the cause-effect relationship between retinal detachment and blunt retinal detachment and to ocular trauma in forensic medical assessment. Methods 112 cases of forensic medical examination on post-traumatic retinal detachment were retrospectively analyzed. Results A variety of retinal abnormalities were found in these cases, including tearing of the ora serrata retinae （4.28%）, macular perforation （12.50%）, small （〈90°） nonmacular retinal perforation （56.25%）, larger （〉90°） retinal perforation （5.00%）, and tractive retinal detachment without perforation （11.6%）. Proliferative vitreoretinopathy （PVR） was found in 45 eyes examined. In most cases, retinal detachment occurred between 1 week to 2 months after blunt ocular trauma （61.60%）, with 83.93% accompanied with severe myopia （〉-3.00D） and 52.67% accompanied with vitreous floaters. Of all cases, 41.07% were directly and 52.68% were indirectly resulted from blunt ocular trauma, and the rest （6.25%） showed no association with blunt ocular trauma. Conclusion Many risk factors may result in retinal detachment including blunt ocular trauma and other causes. Accurate assessment of the relationship between blunt ocular trauma and retinal detachment is an important part of forensic examination.

关 键 词：视网膜脱离 眼部钝挫伤 因果关系 

分 类 号：R774.12[医药卫生—眼科]