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软组织型颈椎病的生物力学评估及低速碰撞中的专家意见

Biomechanical assessment of soft tissue cervical spine disorders and expert opinion in low speed collisions.

作者信息

Walz F H, Muser M H

机构信息

Institute for Biomedical Engineering, Zurich, Switzerland.

出版信息

Accid Anal Prev. 2000 Mar;32(2):161-5. doi: 10.1016/s0001-4575(99)00086-x.

Abstract

The multidisciplinary research of injury mechanisms and injury prevention requires the assessment of the technical and biomechanical circumstances of a collision; moreover, the causality assessment in the individual cases is facilitated by taking these aspects into account. In fact, only specially trained engineers and biomechanical experts are in a position to evaluate these relevant basic facts. In many crucial court cases, important technical factors such as collision angle, structural stiffness, extent of intrusion and the vehicle's velocity change are often ignored. The purely medical causality assessment is often based only on a coincidence of time of the 'accident' and the onset of the disorders. Unfortunately, statements about the 'accident speed' or the nebulous 'accident energy' are often made by clinicians with neither a proper collision documentation nor the necessary biomechanical and technical background. In order to overcome shortcomings of injury causality assessment as well as the terminology associated with soft tissue cervical spine injuries, a subdivision of the term 'accident severity' into four classes is proposed. Consequently, an 'accident severity assessment' can only be performed by a collaboration of four corresponding classes of experts, i.e. the engineer (dynamic loading of the vehicle), the biomechanical expert (biomechanical loading of the occupant), the physician (clinically diagnosable injuries), and eventually the psychiatrist (subjective sequelae individually experienced by the victim).

摘要

对损伤机制和损伤预防的多学科研究需要评估碰撞的技术和生物力学情况;此外,考虑这些方面有助于对个别案例进行因果关系评估。事实上,只有经过专门培训的工程师和生物力学专家才能评估这些相关的基本事实。在许多关键的法庭案件中,碰撞角度、结构刚度、侵入程度和车辆速度变化等重要技术因素常常被忽视。纯粹的医学因果关系评估往往仅基于“事故”发生时间与疾病发作时间的巧合。不幸的是,临床医生在既没有适当的碰撞记录,也没有必要的生物力学和技术背景的情况下,常常会对“事故速度”或模糊的“事故能量”发表看法。为了克服损伤因果关系评估的缺点以及与颈椎软组织损伤相关的术语问题,建议将“事故严重程度”一词细分为四类。因此,“事故严重程度评估”只能由四类相应的专家合作进行,即工程师(车辆的动态载荷)、生物力学专家(乘员的生物力学载荷)、医生(临床可诊断的损伤),以及最终的精神科医生(受害者个人经历的主观后遗症)。

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