上泪小管断裂的法医学鉴定分析

Forensic Analysis of Upper Lacrimal Canaliculus Break

摘要: 目的：提高法医鉴定人对上泪小管断裂人体损伤程度鉴定的认识。方法：回顾性分析上泪小管断裂的鉴定案例1例，探讨其损伤机制、泪河高度(TMH, tear meniscus height)的法医学应用，对现有条款提出一些建议，并结合文献进行复习。结果：老年男性，因眼外伤致上泪小管断裂且主诉溢泪，行左眼泪道冲洗，上冲原位返，眼表综合分析仪示双眼TMH均为0.16 mm，排除溢泪，最终鉴定意见为轻微伤。结论：上泪小管断裂在泪器损伤中较为少见且鉴定无详细释义指导，TMH可作为溢泪的一项客观辅助检测手段，建议明确溢泪的诊断标准，对辅助检查种类、检查时机、检查次数等做出具体规定。

Abstract: Objective: To improve the appraiser’s understanding of the identification of human injury with upper lacrimal canaliculus break. Methods: A retrospective analysis of an identification case of upper lacrimal canaliculus break was conducted to explore the damage mechanism, the forensic application of TMH and some opinions on the existing clauses, and relevant literature was reviews. Results: The appraised individual, an old male, suffered a break of the upper lacrimal canaliculus. The left eye’s lacrimal duct was obstructed, and the complaint was epiphora. Because the ocular surface comprehensive analyzer showed that TMH in both eyes was 0.16 mm, the epiphora was ruled out. Conclusion: Upper lacrimal canaliculus break is relatively rare in lacrimal organ injuries and there is no detailed interpretation guide. TMH can be used as an objective auxiliary detection method for epiphora. It is recommended to clarify the diagnostic criteria for epiphora, and to make detailed regulations on the type of auxiliary examination, the time and the frequency of examination.