肩关节损伤致肢体功能障碍程度评价方法比较

目的探讨能客观反映肩关节功能障碍对肢体功能影响的评价方法。方法通过用我国《道路交通事故受伤人员伤残评定》（简称＂《道标》＂）的权重指数法与美国《永久残损评定指南》（Guides to the Evaluation of Permanent Impairment,GEPI）（简称GEPI法）,对133例肩关节损伤后伤残评定案例进行回顾性评价;并用两种评价方法对肩关节不同运动方向及不同活动度对上肢功能影响进行全方位的比较。结果 133例肩关节功能障碍案例,权重指数法达到伤残的总比例高于GEPI法;但在功能丧失不同比例段两者有差异。差异的原因在于,在GEPI法中,肩关节不同运动方向所占的权重不同,前屈上举与外展上举对于肩关节功能相对重要,并考虑关节功能位对肢体障碍程度的影响;而权重指数法,上肢功能的关系与关节活动度呈简单的线性关系,与关节活动方向及功能位无关。结论 GEPI法比权重指数法能更能客观地反映肩关节功能障碍对肢体功能丧失的影响程度。

Comparison of the Evaluation Methods for Upper Limb Dysfunction Caused by Shoulder Joint Injury

Objective To study the evaluation methods for limb dysfunction caused by shoulder joint injury. Method 133 shoul-der joint injury cases caused by shoulder movement dysfunction were analyzed and evaluated according to Assessment for Body Impairment of Injuries in Road Traffic Accident （ABIR） and Guides to Evaluation of Permanent Impairment （GEPI）, respec- tively. The degrees of upper limb impairment and the impact of different directions and activities of shoulder joint on upper limb function were compared based on these two standards. Results In the 133 cases, the percentage of disability assessed by the ABIR method was higher than that by the GEPI method. But there were differences in different function losing sections. The rea-sons are that the GEPI method provides that different directions have different weights, while the ABIR method provides that the upper limb function has linear relation with the range of motion, but no relation with directions and functional positions. Conclu-sion The GEPI method can more objectively reflect limb dysfunction caused by shoulder joint injury than the ABIR method.