基于颅骨及四肢骨骨折程度推测坠落高度  

Prediction of Falling Height Based on the Fracture Degreeof Skull and Extremity Bones

作　　者：高飞 杨宁 戴运达 张启宇 汤艺坤 赵虎[1] GAO Fei;YANG Ning;DAI Yun-da;ZHANG Qi-yu;TANG Yi-kun;ZHAO Hu(Faculty of Forensic Medicine,Zhongshan School of Medicine//Guangdong Province Translational Forensic Medicine Engineering Technology Research Center,Sun Yat-sen University,Guangzhou 510080,China;Yuexiu Branch of Guangzhou Public Security Bureau,Guangzhou 510055,China)

机构地区：[1]中山大学中山医学院法医学系//广东省法医学转化医学工程技术研究中心,广东广州510080 [2]广州市公安局越秀区分局,广东广州510055

出　　处：《中山大学学报（医学科学版）》2020年第5期726-731,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省法医学转化工程技术研究中心2019年开放课题(2019-01)。

摘　　要：【目的】探索高坠所致的颅骨及四肢骨的骨折程度与坠落高度的相关性。【方法】收集2014年6月至2018年5月发生在广州市越秀区、具有颅骨骨折和(或)四肢骨骨折且无中间障碍物及接触面为硬质平面的高坠案例共66例。根据《人体损伤程度鉴定标准》的线性、粉碎性及开放性3种骨折形态等级分别赋值1~3分,并参考《简明损伤定级标准2005》损伤区域计算最大AIS值(MAIS)。针对坠落高度(Y)与颅骨骨折程度(X1)、四肢骨骨折程度(X2)、年龄(X3)、性别(X4)等因素进行多重线性回归分析。【结果】年龄是骨折程度的分级与定量的影响因素。颅骨和四肢骨的骨折程度与坠落高度均具有正相关性(分别为r1=0.698和r2=0.780)。坠落高度的线性回归方程:Y(m)=6.660+2.843 X1+2.664 X2-0.099 X3,R2=0.871,误差为±4.577 m。【结论】研究提示颅骨和四肢骨的骨折程度是推测坠落高度的重要指标。经案例验证与高度阈值检验,回归方程具有较好的实际应用价值。【Objective】To explore the correlation between the falling height and the fracture degree of skull and extremity bones.【Methods】A total of 66 cases of high falls with no-obstacles and hard contact surface that occurred in Yuexiu District of Guangzhou from June 2014 to May 2018 were collected,in which only fractures of skull and(or)extrem⁃ity bones were observed.Of these cases,1 to 3 points were assigned to linear fractures,comminuted fractures,and open fractures respectively in reference to“Human Injury Degree Appraisal Standard”,and each site of fractures could receive a unique maximal abbreviated injury scale(MAIS)value from Abbreviated Injury Scale(AIS)2005.The sum of unique MAIS to different fracture sites indicated the total severity of those fractures(FT).Multiple linear regression analysis was performed on the falling height(Y)and FT of skull and extremity bones,age and gender.【Results】Age was an influen⁃tial factor in the classification and quantification of fracture degree.There was a strong positive correlation between skull FT or extremity bones FT(r1=0.698 or r2=0.780)and Y,Y(m)=6.660+2.843×skull FT+2.664×extremity bones FT-0.099×Age,R2=0.871,SE=±4.577 m.【Conclusion】Our results suggest that the total severity of skull fracture⁃sand extremity bones fractures are two important indicators for the prediction of falling height.The mathematical model for prediction of falling height may be practical and applicable in related studies for the reason that it is confirmed in the earlier literatures.

关 键 词：颅骨 四肢骨 骨折程度 坠落高度 线性回归 

分 类 号：DF795.1[医药卫生—法医学]