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目的探讨颅脑损伤所致的精神障碍类型,以及颅脑损伤受损程度、范围及距鉴定间隔时间与智力损害程度的关系。方法对182例颅脑损伤患者的司法精神医学鉴定资料进行回顾性分析。结果(1)182例颅脑损伤所致精神障碍者中,以智力障碍为首位,共123例次(67.6%)。(2)伤残等级评定为Ⅶ～Ⅹ级者共142例(78.0%)。(3)智力损害程度与受伤时间距鉴定时间无相关性(χ2=0.41,P>0.05),但与脑损伤程度有相关性(P<0.05)。(4)有智力损害组的脑干损伤(30.9%)、脑内血肿(25.2%)的比例高于无智力损害组(分别为16.9%和11.9%;P<0.01),≥2个脑叶损伤(61.7%)的比例也高于无智力损害组(34.9%;P<0.05)。结论颅脑损伤所致智力障碍占第1位,脑损伤受损程度与智力损害程度有明显的相关性,伤残等级以Ⅶ～Ⅹ等级的比例高。
Objective To explore the types of mental disorders caused by craniocerebral injury and the extent and range of brain injury damage and the relationship between the interval and the degree of intellectual impairment. Methods A retrospective analysis of 182 patients with traumatic brain injury in the forensic psychiatry identification data were retrospectively analyzed. Results (1) Of the 182 cases of mental disorders caused by traumatic brain injury, 123 cases were the first with mental retardation (67.6%). (2) There were 142 cases (78.0%) with disability grade Ⅶ ~ Ⅹ. (3) There was no correlation between the degree of intellectual impairment and the time of injury from the identification time (χ2 = 0.41, P> 0.05), but there was a correlation between the degree of intellectual impairment and the degree of brain injury (P <0.05). (4) The brainstem injury (30.9%) and intracerebral hematoma (25.2%) in the group with intellectual impairment were higher than that in the group without mental damage (16.9% and 11.9% respectively; P <0.01) The proportion of injuries (61.7%) was also higher than those without mental impairment (34.9%; P <0.05). Conclusions The headache caused by craniocerebral injury occupies the first place. The damage degree of brain injury has obvious correlation with the degree of mental damage. The disability rank is higher than Ⅶ ~ Ⅹ grade.