Lahoti S L, McClain N, Girardet R, McNeese M, Cheung K
Department of Pediatrics, University of Texas Medical School at Houston, USA.
Am Fam Physician. 2001 Mar 1;63(5):883-92.
Child victims of sexual abuse may present with physical findings that can include anogenital problems, enuresis or encopresis. Behavioral changes may involve sexual acting out, aggression, depression, eating disturbances and regression. Because the examination findings of most child victims of sexual abuse are within normal limits or are nonspecific, the child's statements are extremely important. The child's history as obtained by the physician may be admitted as evidence in court trials; therefore, complete documentation of questions and answers is critical. A careful history should be obtained and a thorough physical examination should be performed with documentation of all findings. When examining the child's genitalia, it is important that the physician be familiar with normal variants, non-specific changes and diagnostic signs of sexual abuse. Judicious use of laboratory tests, along with appropriate therapy, should be individually tailored. Forensic evidence collection is indicated in certain cases. Referral for psychologic services is important because victims of abuse are more likely to have depression, anxiety disorders, behavioral problems and post-traumatic stress disorder.
遭受性虐待的儿童受害者可能会出现一些身体检查结果，其中包括肛门生殖器问题、遗尿或遗粪症。行为改变可能涉及性方面的不当行为、攻击行为、抑郁、饮食失调和退行。由于大多数遭受性虐待的儿童受害者的检查结果都在正常范围内或不具有特异性，因此儿童的陈述极为重要。医生所获取的儿童病史可能会在法庭审判中作为证据被采纳；因此，对问题和答案进行完整记录至关重要。应该获取详细的病史，并进行全面的体格检查，同时记录所有检查结果。在检查儿童生殖器时，医生熟悉正常变异、非特异性变化以及性虐待的诊断体征非常重要。应根据个体情况明智地使用实验室检查，并给予适当的治疗。在某些情况下需要收集法医证据。转介接受心理服务很重要，因为虐待受害者更有可能出现抑郁、焦虑症、行为问题和创伤后应激障碍。
