伤残鉴定中智能障碍评定的多因素分析

目的探讨智力测验在智力损伤与伤残鉴定中的适应性。方法对366例在精神损伤或伤残鉴定中进行韦氏智力测验的结果及其影响因素进行分析，并与鉴定专家评定结论进行比较。结果①韦氏智力测验结果与专家鉴定结论之间存在明显差异（P〈0．01），不一致率为68．8％，但二者呈现显著正相关（r=0．431，P〈0．01）。②影响韦氏智力测验的客观因素包括多种身体功能障碍及精神障碍，分别占32．2％（118例）和23．8％（87例）。③在智力测验时表现有主观不合作者为61．5％，而在专家检查中表现有主观不合作者仅为38．8％。结论智力测验受多种主客观因素的影响，不能直接引用评定智力伤残等级，需要结合脑外伤的严重程度、临床检查及社会功能等综合评定智力伤残的等级。

Identification of obstacles to the disabled intelligent assessment of multi-factor analysis

Objective To analysis the application of intelligence test in the intelligent impairment evaluation.Methods To analysis retrospectively the performances of intelligence test and relative factors of 366 cerebral trauma patients in the impairment evaluation and comparing with the results of experts′ diagnosis on intelligent impairment.Results ①There was significant difference between the Wechsler performances of intelligence test and the results of experts'diagnosis on intelligent impairment(P<0.01).The discord rate was 68.8%,but there significant relationship between them(r=0.431,P<0.01).②The object factors to effect the performances of intelligence test involving the somatic functional disorders and mental functional disorders were 32.2%(118 cases)and 23.8%(87cases)respectively.③The fake rate was 61.5% during the process of intelligence test,but within only 38.8% of the mental examination of experts.Conclusion The performances of intelligence test can′t equal to grade of intelligent impairment because many effective factors on it,including object and subject.It should be evaluated combining to cerebral trauma severity degree,clinical examination,social functions and so on.