多层螺旋CT在单侧眶壁骨折及眼球内陷损伤程度法医学鉴定中的应用  

The study of multi spiral CT of unilateral orbital wall fracture and enophthalmos of injury degree evaluation in forensic identification

作　　者：尚敏 张俊涛 许方 杨琦 郭威隆 方霈 李凡[5] SHANG Min;ZHANG Juntao;XU Fang;YANG Qi;GUO Weilong;FANG Pei;LI Fan(Department of Radiology,Zhoushan Branch,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang,He'nan Province 471003,China;Institute of Evidence Law and Forensic Science,China University of Political Science and Law,Beijing 100089,China;Luoyang Public Security,Zhengzhou Railrway Public Security Bureau,Luoyang,He'nan Province 471002,China;He'nan Jinjian Forensic Identification Center,Luoyang,He'nan Province 471001,China;School of Forensic Medicine,He'nan University of Science and Technology,Luoyang,He'nan Province 471023,China)

机构地区：[1]郑州大学附属洛阳中心医院周山院区放射科,河南洛阳471003 [2]中国政法大学证据科学研究院,北京100089 [3]郑州铁路公安局洛阳公安处,河南洛阳471002 [4]河南金剑司法鉴定中心,河南洛阳471001 [5]河南科技大学法医学院,河南洛阳471023

出　　处：《实用放射学杂志》2021年第4期539-542,共4页Journal of Practical Radiology

基　　金：证据科学教育部重点实验室(中国政法大学)开放课题(KFKT03).

摘　　要：目的 探讨多层螺旋CT(MSCT)在单侧眶壁骨折及眼球内陷损伤程度法医学鉴定中的意义.方法 回顾性分析228例单侧眶壁骨折及眼球内陷患者的MSCT资料,分析其性别、年龄、致伤原因及骨折部位、位置、数目等,对眼球内陷情况进行人工眼球突出计测量法及MSCT测量法对比分析.结果 228例患者的致伤原因均为打击(拳击伤),平均年龄(39±13.24)岁,男性占大多数(213/228,93.42%).单侧眶壁骨折以左侧多见(145/228,63.60%),右侧次之(83/228,36.40%);311处眶壁骨折,内侧壁最多(180/311,57.88%),其次为下壁(91/311,29.26%).19例眼球内陷程度达到损伤程度评定标准(≥2.00 mm),其中符合重伤二级标准1例,符合轻伤一级标准18例,其余为轻微伤;其中单纯内侧壁骨折4例(21.05%),单纯下壁骨折3例(15.79%),内侧壁及下壁骨折12例(63.16%).人工眼球突出计测量法及MSCT测量法眼球内陷平均值无统计学差异(P>0.05).结论 MSCT能够对单侧眶壁骨折及眼球内陷做出准确诊断和精准测量,对其损伤程度法医学鉴定有重要的意义.Ojective To explore the significance of multi spiral computed tomography(MSCT)in unilateral orbital wall fracture and enophthalmos of injury degree evaluation in forensic identification.Methods The gender,age,and etiology of 228 patients of unilateral orbital wall fracture and enophthalmos were counted.The fracture site,location,and number were statistically analyzed on the MSCT database.The degree of enophthalmos was measured by the MSCT and manual exophthalmometer,and the results of two methods were comparied.Results The causes of injury of all 228 patients were drect violence,the mean of age was(39±13.24)years,the majority were males(213/228,93.42%).The left orbital wall fracture was more commonly(145/228,63.60%).In the 311 orbital wall fractures,the most location was the inner wall of the orbit(180/311,57.88%),fllowed by the inferior wall(91/311,29.26%).The degree of enophthalmos of 19 cases reached the grade criteria of injury.One case had second degree of serious injury in forensic idenification,and there were 18 cases of first degree of minor injury,and others had slight injury.Among 19 cases of enophthalmos≥2.00 mm,there were 4 cases accompanied by simple inner wall fractures(21.05%).3 cases had simple lower wall fractures(15.79%),and 12 cases had inner and lower wall fractures(63.16%).There was no significant difference in the mean of the MSCT and manual exophthalmometer(P>0.05).Conclusion MSCT could make accurate diagnosis and measurement of unilateral orbital wall fracture and enophthalmos,which has great significance to determine the injury degree in forensic identification.

关 键 词：眶壁骨折 眼球内陷 计算机体层成像 损伤程度 法医学鉴定 

分 类 号：R777.5[医药卫生—眼科] R777.4[医药卫生—临床医学]