30例颅脑外伤性癫痫法医学鉴定的回顾性分析  

Retrospective Analysis of Forensic Appraisal of Post-traumatic Epilepsy in 30 Cases

作　　者：张运阁[1] 李春晓[1] ZHANG Yun-ge;LI Chun-xiao(Institute of Forensic Expertise,Dean Hospital of Changzhou,Changzhou 213003,Jiangsu Province,China)

机构地区：[1]常州市德安医院司法鉴定所

出　　处：《法医学杂志》2019年第3期304-307,共4页Journal of Forensic Medicine

基　　金：常州市科技局应用基础研究资助项目(CJ20159057)

摘　　要：目的总结法医临床学鉴定中外伤性癫痫的一般特点与鉴定注意事项。方法对30例颅脑外伤性癫痫被鉴定人的一般情况(年龄和性别)、损伤部位、外伤性癫痫分度、临床表现、血药浓度等进行描述性统计,对性别构成、年龄组发病情况、损伤部位、临床表现和外伤性癫痫分度的差异进行χ2检验。对各部位在临床表现、外伤性癫痫分度上的差异,不同临床表现上外伤性癫痫分度之间的差异分别进行Fisher精确概率法检验。结果颅脑外伤性癫痫于21~40岁多发,男性多于女性,好发于颞叶和额叶。临床表现上,以部分性发作为主,以轻度外伤性癫痫为多见。损伤部位在临床表现和外伤性癫痫分度上的分布差异均无统计学意义(P>0.05),不同的临床表现上外伤性癫痫分度之间的差异无统计学意义(P>0.05)。3名被鉴定人血药浓度未达有效浓度,影响最终鉴定意见。结论在外伤性癫痫的鉴定中,除了严格掌握鉴定的必要因素,如颅脑外伤史、癫痫发作情况等,建议重视血药浓度检测,全面分析,综合评定。Objective To summarize the general characteristics and identification considerations of appraisal of post-traumatic epilepsy (PTE) in forensic clinical expertise. Methods Descriptive statistics were made on the general situations (age and sex), injury sites, PTE grading, clinical manifestations and blood drug concentrations of 30 cases of PTE. Chi-square test was performed on the differences of sex composition, age group incidences, injury sites, clinical manifestations and PTE grading. Fisher’s exact probability method was used to test the differences in clinical manifestations and PTE grading of each site and the differences in PTE grading of different clinical manifestations. Results PTE occurred more frequently among 21 to 40 year olds, more in males than in females, and more frequently in the temporal lobe and frontal lobe. The clinical manifestations were mostly partial seizures and the PTE grading was mostly mild PTE. There were no statistical significance in the differences in distribution of clinical manifestations and PTE grading of injury sites (P>0.05). The difference in the PTE grading of different clinical manifestations had no statistical significance (P>0.05). The blood drug concentration of the three identified people did not reach the effective concentration, which affected the final identification opinion. Conclusion In the identification of PTE, in addition to strictly grasping the necessary factors of identification, such as the history of craniocerebral trauma, and epileptic seizures, it is also suggested that attention should be paid to the detection of blood drug concentration. Overall analysis and comprehensive evaluation should be made.

关 键 词：法医学 癫痫 创伤后 颅脑损伤 案例分析 

分 类 号：DF795.1[医药卫生—法医学]