不同部位颅脑摔跌伤的特征分析68例  

Analysis of 68 tumbling injury cases by falling from different part of the head

作　　者：郑剑[1] 刘宁国[2] 邹冬华[2] 张建华[2] 赵辉林[3] 陈忆九[2] 

机构地区：[1]南昌大学医学院法医学教研室,江西南昌330006 [2]司法部司法鉴定科学技术研究所上海市法医学重点实验室,上海200063 [3]上海交通大学附属仁济医院影像科,上海200127

出　　处：《中国法医学杂志》2010年第6期425-427,共3页Chinese Journal of Forensic Medicine

基　　金：中央级科研院所社会公益研究专项(GY0706);国家自然科学基金面上项目(30872920)

摘　　要：目的探讨不同受力部位颅脑摔跌伤后损伤程度和特征差异。方法收集摔跌所致颅脑损伤68例,根据案情、受伤过程、临床体征、CT影像资料将受伤部位分为颅前部、颅侧部、颅后部;损伤类型分为颅骨骨折、硬脑膜外血肿、硬脑膜下血肿和脑挫裂伤;损伤数量分为单一和多发伤;颅骨骨折分为受力点骨折和非受力点骨折;脑挫裂伤分为冲击伤、对冲伤等。运用非参数统计χ2检验比较其频数分布。结果不同摔跌部位颅骨骨折和颅脑损伤程度存在明显差异(P<0.05),颅后部摔跌颅骨骨折远离受力点多见,多发伤为主,而颅前部、颅侧部受力点骨折多见,单处损伤多见;颅后部、颅侧部摔跌后脑挫裂伤发生率高,以对冲部位多见,颅前部摔跌后脑挫裂伤发生率低,冲击伤亦多见。结论摔跌部位不同颅脑损伤程度和特征存在差异,CT检查资料有助于损伤机制推断。Objective To investigate the injury degree and the character of the cranio-cerebral injury by falling from different parts of the head.Methods 68 cases of tumbling injury were divided into foreside-injury-group,lateral-injury-group and rearward-injury-group according to the forced part of the head.The forced part was confirmed by the detail of the case,the course of the injury,clinical symptom and computed tomography.Only four types of injury were concerned,and they are cranio fracture,extradural hemorrhage,subdural hemorrhage and brain contusion.The injury was classified as single lesion and multiple injuries according to the injury area.The cranio fractures were classified as force-bearing-point fracture and non-force-bearing-point fracture,and the brain contusions as contrecoup and coup lesions respectively.Then the pearson χ2 was used to analyze the frequency distribution.Results The character of cranio fracture and cranio-cerebral injury degree were significantly different between the groups which fell from different parts of the head（P〈0.05）.Cases in rearward-injury-group were more likely to have non-force-bearing-point fracture and multiple injuries while cases in foreside-injury-group and lateral-injury-group were more likely to have force-bearing-point fracture and single injury.Also the majority cases in the rearward-injury-group and lateral-injury-group often suffer contrecoup lesion while cases in the foreside-injury-group is less common.And if any,coup lesion was more common.Conclusion The injury degree and the characters of cranio-cerebral injury differed between the groups which fell from different parts of the head;CT image was helpful for investigating the mechanism of cranio-cerebral injury.

关 键 词：法医损伤学 颅脑损伤 摔跌伤 CT 

分 类 号：D919[医药卫生—法医学]