道路交通事故中脑外伤所致人格改变与精神伤残评定

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(P0.05),但各组之间量表总分差异具有统计学意义(P0.05),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(P0.05),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(P0.05)。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。

Personality Change due to Brain Trauma Caused by Traffic Accidents and Its Assess-ment of Psychiatric Impairment

Objective To explore the m ain perform ance of personality change in people w ith m ild psy-chiatric im pairm ents w hich due to the brain traum a caused by traffic accidents and its value in assess-m ent of psychiatric im pairm ent. Methods The condition of personality change of patients w ith traum atic brain injury caused by traffic accident w as evaluated by the Scale of Personality Change Post-traum atic Brain Injury (SPCPTBI). Furtherm ore, the correlation betw een the personality change and the degrees of traum atic brain injury and psychiatric im pairm ent w ere explored. Results In 271 sam ples, 239 (88.2% ) w ith personality changes. A m ong these 239 sam ples, 178 (65.7% ), 46 (17.0% ), 15 (5.5% ) w ith m ild, m oderate and severe personality changes, respectively. The ratio based on the extent of personality changes to the degree of brain traum a w as not significant (P>0.05), but the total score difference betw een the groups w as significant (P<0.05). There w as no statistical significance betw een the m edium and high severity brain traum a groups. The higher degree of personality changes, the higher rank of m ental disabilities. The total score difference of the scale of personality change am ong the different m ild psychiatric im pair-m ent group w as significant (P<0.05). The difference betw een other psychiatric im pairm ent levels had statistical significance (P<0.05) except level 7 and 8. Conclusion The occurrence of personality change due to traum atic brain injury caused by traffic accident w as high. Correlations exist betw een the personality change and the degree of psychiatric im pairm ent. Personality change due to brain traum a caused by traffic accident can be assessed effectively by m eans of SPCPTBI, and the correlation betw een the total score and the extent of traum atic brain injury can be found.