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目的:以交通事故中受到单一肢体功能损伤的患者作为研究对象,总结伤残评定经验,并分析GB18667-2002《道路交通事故受伤人员伤残评定》(以下简称《道标》)之不足,提出改进意见。方法:筛选2015年2月-2015年12月,司法鉴定中心受理的交通事故损失鉴定案例100例,调取患者案例资料,参照《道标》中规定的相应部分伤残功能权重体系,计算功能丧失程度,评定伤残等级,参照美国医学会(AMA)制定的GPI查表法,得出肢体功能丧失程度,采用FMA法,评价患肢功能障碍,采用Barthel指数评价患者日常活动能力(ADL),2位法医学医师独立双盲法完成,不同意见协商解决。结果:ADL评分63-92分、平均(72±8)分,FMA评分11-89分、平均(43±20)分。GPI法72-91分、平均(74±7)分;ADL、FMA运动与功能障碍秩和检验差异具有统计学意义(u=11.350,P<0.05);将ADL评分与损失部位、FMA法、GPI法、伤残评定查表法存在显著相关性,与伤残评定查表法相关性系数最高。结论:《道标》联合查表法仍是反映患者ADL的重要敏感性指标,有较高的应用价值,但受其他许多因素影响,应适当补充相应条款,注重整体功能评价,适当考虑伤情对远期预后影响。
OBJECTIVE: To summarize the experience of disability assessment for patients with single limb injury in traffic accident and to analyze the shortcomings of GB18667-2002 “Disability Assessment of Injured Personnel in Road Traffic Accident” (hereinafter referred to as “Road Mark”) Improve your opinion. Methods: From February 2015 to December 2015, 100 cases of accidental loss cases accepted by forensic laboratories were screened out. Case data of patients were retrieved and the disability functional weighting system stipulated in “Road Marking” The degree of disability was assessed and the level of disability was assessed. The extent of limb dysfunction was determined according to the GPI look-up table established by the American Medical Association (AMA). FMA was used to evaluate the limb dysfunction. Barthel index was used to evaluate the daily activities of patients (ADL) , Two forensic physicians independent double-blind method to complete, different opinions negotiated settlement. Results: The ADL score was 63-92 with an average of (72 ± 8) points and the FMA score was 11-89 with an average of (43 ± 20) points. GPI was 72-91 (mean, 74 ± 7); ADL, FMA rank sum test was significant (u = 11.350, P <0.05); ADL score and loss sites, FMA, GPI method, disability assessment of the tabulation method has significant correlation, and disability assessment tabulation method correlation coefficient highest. CONCLUSION: The combination of “Dao Biao” and joint look-up table is still an important sensitive index which reflects the ADL of patients and has a high value of application. However, due to many other factors, the corresponding clauses should be appropriately supplemented, with emphasis on the overall functional assessment and due consideration of the injury Impact on long-term prognosis.