道路交通事故中脑外伤所致人格改变与精神伤残评定  

Personality Change due to Brain Trauma Caused by Traffic Accidents and Its Assessment of Psychiatric Impairment

作　　者：樊慧雨 张钦廷[1,2] 汤涛[1] 蔡伟雄[1] 

机构地区：[1]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 [2]上海交通大学医学院附属精神卫生中心,上海200032

出　　处：《法医学杂志》2016年第2期100-104,共5页Journal of Forensic Medicine

基　　金：国家自然科学基金资助项目(81001354)

摘　　要：目的探索道路交通事故中颅脑损伤所致轻度精神伤残者人格改变的主要表现形式及其在伤残评定中的价值。方法运用《脑外伤后人格改变评定量表》量化评定道路交通事故所致颅脑外伤者后遗人格改变状况,并探讨人格改变与颅脑损伤程度、精神伤残程度的相关性。结果 271例样本中239例(88.2%)存在人格改变,其中178例(65.7%)为轻度,46例(17.0%)为中度,15例(5.5%)为重度。人格改变程度在不同颅脑损伤程度之间的构成比差异无统计学意义(P>0.05),但各组之间量表总分差异具有统计学意义(P<0.05),两两比较显示中型与重型颅脑损伤之间差异无统计学意义。人格改变程度越明显,精神伤残等级越高,轻度精神伤残不同等级者人格改变评定量表总分差异具有统计学意义(P<0.05),除七级与八级之间差异无统计学意义外,其余各组之间差异均具有统计学意义(P<0.05)。结论交通事故中提出精神伤残评定的脑外伤者中人格改变发生比例较高,人格改变严重程度与精神伤残程度相关,《脑外伤后人格改变评定量表》能有效量化评定交通事故中脑外伤所致人格改变程度,量表总分与颅脑损伤程度具有相关性。Objective To explore the main performance of personality change in people with mild psychiatric impairments which due to the brain trauma caused by traffic accidents and its value in assessment of psychiatric impairment. Methods The condition of personality change of patients with traumatic brain injury caused by traffic accident was evaluated by the Scale of Personality Change Post-traumatic Brain Injury （SPCPTBI）. Furthermore, the correlation between the personality change and the degrees of traumatic brain injury and psychiatric impairment were explored. Results In 271 samples, 239 （88.2%） with personality changes. Among these 239 samples, 178 （65.7%）, 46 （17.0%）, 15 （5.5%） with mild, moderate and severe personality changes, respectively. The ratio based on the extent of personality changes to the degree of brain trauma was not significant （P〉0.05）, but the total score difference between the groups was significant （P〈0.05）. There was no statistical significance between the medium and high severity brain trauma groups. The higher degree of personality changes, the higher rank of mental disabilities. The total score difference of the scale of personality change among the different mild psychiatric impairment group was significant （P〈0.05）. The difference between other psychiatric impairment levels had statistical significance （P〈0.05） except level 7 and 8. Conclusion The occurrence of personality change due to traumatic brain injury caused by traffic accident was high. Correlations exist between the personality change and the degree of psychiatric impairment. Personality change due to brain trauma caused by traffic accident can be assessed effectively by means of SPCPTBI, and the correlation between the total score and the extent of traumatic brain injury can be found.

关 键 词：司法精神病学 颅脑损伤 事故 交通 人格改变 精神伤残 

分 类 号：R641[医药卫生—外科学]