摘要
目的探讨外伤性玻璃体积血的特点及法医学鉴定要点。方法选择2013年6月—2018年6月期间,某省级眼科医院76例(共76眼)有明确眼外伤史的玻璃体积血案例资料进行回顾性研究,所有案例均常规行全面的视力、屈光度、裂隙灯、眼压、眼B超、VEP、ERG、彩色眼底照相、OCT、视野、FFA、UBM、眼部CT(或MRI)等眼科检查。结果玻璃体积血的多少,依据玻璃体混浊程度分为四级,在眼B超图像上分为少量、中量及大量积血;积血有自行吸收的可能,积血量的多少以及有无并发症直接影响视力的恢复情况;视力下降通常可得到一定程度的恢复,据此确定的损伤程度可为轻伤二级、轻伤一级、重伤二级。结论外伤性玻璃体积血具有一定特征性,由玻璃体积血引起的视力下降可以影响鉴定结果,鉴定时限为3~6月,可依具体伤情延长至满6个月,眼B型超声诊断是重要的检查手段。
Objective To investigate the characteristics of traumatic vitreous hemorrhage and the key points of forensic science.Methods From June 2013 to June 2018,76 cases(76 eyes)of vitreous hemorrhage with a clear history of ocular trauma in a provincial ophthalmic hospital were retrospectively studied.All cases underwent detailed routine visual acuity,diopter,slit lamp,intraocular pressure,B-mode ultrasonography,VEP,ERG,color fundus photography,OCT,visual field,FFA,UBM,and ocular CT(or MRI)and other eye examinations.Results The amount of vitreous hemorrhage was divided into four grades according to the degree of vitreous turbidity.The amount of vitreous hemorrhage was divided into a small amount,a medium amount and a large amount of hemorrhage on B-mode ultrasonography images.Hemorrhage could be absorbed by itself.The amount of hemorrhage and complications directly affected the prognosis of visual acuity.Visual acuity decline was likely to improve.The degree of injury to a minor two,minor one,injured two.Conclusion Traumatic vitreous hemorrhage has certain characteristics.The visual acuity deterioration caused by vitreous hemorrhage can affect the identification conclusion.The identification time is 3-6 months and can be extended to 6 months according to the specific condition of the injury.Eye B-mode ultrasound diagnosis is an important means of examination.
作者
王元兴
姚博
刘健
徐进宝
陈智会
WANG Yuanxing;YAO Bo;LIU Jian;XU Jinbao;CHEN Zhihui(Forensic Science Service of Haidian Branch of Beijing Public Security Bureau,Beijing 100142,China;Criminal Investigation Brigade of Haicang Branch of Xiamen Public Security Bureau,Xiamen 361026,China;Eye Hospital China Academy Of Chinese Medical Sciences,Beijing 100040,China;Wanquan Branch of Zhangjiakou Municipal Public Security Bureau,Zhangjiakou 076250,China)
出处
《中国司法鉴定》
2020年第5期33-37,共5页
Chinese Journal of Forensic Sciences
关键词
法医临床学
玻璃体积血
法医学鉴定
forensic clinical medicine
vitreous hemorrhage
forensic identification
