【摘要】： 目的：研究道路交通事故胸腹部傷亡的流行病學(xué)特點(diǎn)和人體胸腹部損傷機(jī)制；探討道路交通事故胸腹部受傷人員的傷殘發(fā)生、分布特點(diǎn)及合理的評(píng)定時(shí)限，為預(yù)防、控制道路交通事故和臨床法醫(yī)學(xué)應(yīng)用提供依據(jù)；探討交通事故胸腹部受傷人員后期醫(yī)療費(fèi)用的影響因素，并為此類案例后期醫(yī)療費(fèi)用的法醫(yī)學(xué)評(píng)估積累經(jīng)驗(yàn)。方法：應(yīng)用統(tǒng)計(jì)學(xué)方法和法醫(yī)學(xué)技術(shù)對(duì)2004年和2005年昆明地區(qū)道路交通事故死亡210例胸腹部損傷法醫(yī)病理鑒定資料和247例胸腹部損傷法醫(yī)臨床檢驗(yàn)鑒定資料進(jìn)行系統(tǒng)性分析研究。結(jié)果：本組457例交通事故胸腹部傷亡案例男性297例(65.0％)，女性160例(35.0％)，年齡分布呈偏態(tài)分布，18～59歲占事故人數(shù)的74.4％。職業(yè)分布以農(nóng)民所占比例最高。事故發(fā)生的時(shí)間分布以9～12時(shí)最高，占22.8％，少年兒童(1-17歲)事故時(shí)間以16—19時(shí)最高，占27.1％；老年人(60歲以上)事故時(shí)間以9—12時(shí)最高，占33.3％。肇事車輛在死亡分組中以大型機(jī)動(dòng)車肇事為主，傷殘分組則以微型車肇事最多。死亡原因以胸部損傷為主，行人和非機(jī)動(dòng)車駕駛員占事故損傷人員總數(shù)的60.7％。摔跌傷以摩托車駕駛員和乘客最為多見，碾壓傷以車外人員多于車內(nèi)人員，車外人員之間無差異。合并傷中，會(huì)陰部損傷在摩托車駕駛員和非機(jī)動(dòng)車駕駛員的構(gòu)成比最高。乘客和非機(jī)動(dòng)車駕駛員發(fā)生椎體損傷比例高。247例交通事故胸腹部損傷傷殘?jiān)u定中Ⅷ—ⅹ級(jí)占總數(shù)的94.4％，行人和非機(jī)動(dòng)車駕駛員傷殘人數(shù)最多且傷殘級(jí)別較高。傷殘人員以青中年為主，占總數(shù)的75.1％。胸腹部傷殘后遺癥以活動(dòng)障礙最為多見，且以非機(jī)動(dòng)車駕駛員最易發(fā)生。后期傷殘?jiān)u定時(shí)間傷后3-6個(gè)月進(jìn)行傷殘?jiān)u定的例數(shù)最多，占總數(shù)的66.8％，后期醫(yī)療費(fèi)用多集中在2-4千，占63.4％。在3-4個(gè)月進(jìn)行后期醫(yī)療費(fèi)用評(píng)估的例數(shù)最多，占總數(shù)的34.0％。結(jié)論：道路交通事故胸腹部傷亡年齡分布以18-59歲人群事故發(fā)生率最高，少年兒童事故時(shí)間以16—19時(shí)最高，老年人事故時(shí)間以9—12時(shí)最高；胸腹部損傷類型包括碰撞傷、碾壓傷、拖擦傷、摔跌傷、擠壓傷及砸壓傷；不同車輛造成損傷的形成機(jī)制中，傷亡人員以碰撞傷為主。胸腹部傷殘椎體損傷例數(shù)最多，，且大型機(jī)動(dòng)車造成椎體損傷例數(shù)多且損傷最為嚴(yán)重。傷殘等級(jí)分布以輕度傷殘為主，后期傷殘?jiān)u定時(shí)間和后期醫(yī)療費(fèi)用評(píng)估均需要考慮多種影響因素綜合判斷。交通事故傷后3—6個(gè)月進(jìn)行評(píng)定較合適。
[Abstract]:Objective: to study the epidemiological characteristics of thoracic and abdominal injuries in road traffic accidents and the mechanism of human thoracoabdominal injuries. To explore the occurrence, distribution characteristics and reasonable evaluation time limit of injury in chest and abdomen of road traffic accident, to provide basis for prevention and control of road traffic accident and application of clinical forensic medicine. To explore the influencing factors of the late medical expenses of the injured persons in the chest and abdomen of traffic accident and to accumulate experience for the forensic evaluation of the late medical expenses in this kind of cases. Methods: the forensic pathological data of 210 cases of road traffic accidents in Kunming in 2004 and 2005 and 247 cases of chest and abdomen injuries were analyzed and analyzed systematically by using statistical method and forensic techniques. Results: there were 297 cases (65.0%) in males and 160 cases (35.0%) in females in 457 traffic accidents. The age distribution was skewed, and 1859 years old accounted for 74.4% of the total number of accidents. Occupation distribution is the highest proportion of farmers. The distribution of the time of the accident was the highest from 9 to 12:00, accounting for 22.8. the time of the accident for the children (1-17 years old) was the highest at 16-19 hours, accounting for 27.1 hours. The accident time of the elderly (over 60 years old) was the highest at 9-12, accounting for 33. 3%. In the death group, large vehicles were the main cause of accidents, and minor vehicles were the most frequent ones in the disability group. Chest injury was the leading cause of death, and pedestrian and non-motor vehicle drivers accounted for 60.7% of the total number of injuries. Motorcycle drivers and passengers were the most common injuries, and crush injuries were more than those inside the vehicle, but there was no difference between them. Among the combined injuries, the ratio of perineum injury was the highest among motorcycle drivers and non-motor vehicle drivers. The ratio of vertebral body injury to passengers and non-motor vehicle drivers was high. In 247 cases of traffic accidents, 鈪

本文編號(hào)：2404017