Adams J A, Girardin B, Faugno D
University of California, San Diego Medical Center, San Diego, CA 92103-8449, USA.
J Pediatr Adolesc Gynecol. 2001 Nov;14(4):175-80. doi: 10.1016/s1083-3188(01)00126-7.
To document the frequency and types of genital injuries in adolescent women examined acutely following a sexual assault, and determine any historical correlates of injury.
Retrospective chart review.
Sexual Assault Response Team services at a community hospital in an urban setting.
All female patients aged 14-19 yr who were referred by law enforcement for an acute sexual assault examination and were examined between May 1994 and May 1999.
The frequency of signs of genital trauma at various anal and genital sites, as recorded by the examining clinician.
Charts of 214 female subjects (mean age 16.3 yr) were reviewed. The most common findings were posterior fourchette tear (36%); erythema of the labia minora, hymen, cervix, or posterior fourchette (18%-32%); and swelling of the hymen (19%). Time to examination was highly correlated with the degree of injury noted (P =.000). The incidence of hymenal tears in self-described virgins was higher than in nonvirgins (19% vs. 3%, P =.008); however, the total number or severity of other injuries was not significantly higher in virgins. Victims reporting anal penetration had a higher frequency of anal injuries than those who denied such contact (14/31, 61% vs. 2/150, 1%; P =.000).
Tears of the posterior fourchette or fossa were the most common findings (40%). Hymenal tears were uncommon, even in self-described virginal girls. Timely examination of adolescent victims is important to document injuries; however, many victims will still not have signs of bruising, abrasions, or tears.
记录遭受性侵犯后接受紧急检查的青春期女性生殖器损伤的频率和类型，并确定损伤的任何历史相关因素。
回顾性图表审查。
城市环境中一家社区医院的性侵犯应对小组服务处。
所有14至19岁的女性患者，她们由执法部门转介进行急性性侵犯检查，并于1994年5月至1999年5月期间接受了检查。
检查医生记录的各个肛门和生殖器部位生殖器创伤迹象的频率。
对214名女性受试者（平均年龄16.3岁）的图表进行了审查。最常见的发现是后穹窿撕裂（36%）；小阴唇、处女膜、宫颈或后穹窿红斑（18%-32%）；以及处女膜肿胀（19%）。检查时间与所记录的损伤程度高度相关（P = 0.000）。自称处女的女性处女膜撕裂的发生率高于非处女（19%对3%，P = 0.008）；然而，处女中其他损伤的总数或严重程度并没有显著更高。报告有肛门插入的受害者肛门损伤频率高于否认有此类接触的受害者（14/31，61%对2/150，1%；P = 0.000）。
后穹窿或隐窝撕裂是最常见的发现（40%）。处女膜撕裂并不常见，即使在自称处女的女孩中也是如此。及时检查青春期受害者对于记录损伤很重要；然而，许多受害者仍不会有瘀伤、擦伤或撕裂的迹象。
