Nationwide Children's Hospital, Columbus, OH 43205, USA.
J Pediatr Health Care. 2009 Sep-Oct;23(5):283-8. doi: 10.1016/j.pedhc.2008.05.003. Epub 2008 Jul 16.
Sexual abuse is a problem of epidemic proportions in our society. Given the prevalence of sexual abuse, it is vital for medical providers, including pediatric nurse practitioners, to recognize sexual abuse in their patients and respond appropriately. Failing to recognize sexual abuse can leave children at risk for continued abuse and potentially lead to the sexual abuse of additional children. Serious ramifications also can arise when sexual abuse is diagnosed erroneously. Children can be removed from their homes and placed in foster care. An innocent person can be prosecuted. It is important for pediatric nurse practitioners to understand that the majority of children who are sexually abused will have a normal or nonspecific ano-genital examination. However, physical findings of sexual abuse are noted in approximately 4% of children who give a history of sexual abuse. Certain clinical findings can mimic sexual abuse. This article will discuss some of the more common findings mistaken for sexual abuse and assist the pediatric nurse practitioner in correctly recognizing these findings and responding appropriately.
性虐待是我们社会中具有流行程度的问题。鉴于性虐待的普遍性，医疗保健提供者，包括儿科执业护士，识别患者中的性虐待并做出适当反应至关重要。未能识别性虐待会使儿童面临持续虐待的风险，并可能导致更多儿童遭受性虐待。当性虐待被误诊时，也会产生严重的后果。儿童可能会被从家中带走并安置在寄养家庭中。无辜的人可能会被起诉。儿科执业护士必须了解，大多数遭受性虐待的儿童的肛门生殖器检查结果正常或无特异性。然而，有性虐待史的儿童中约有 4%会出现性虐待的体格检查结果。某些临床发现可能类似于性虐待。本文将讨论一些常见的被误认为性虐待的发现，并帮助儿科执业护士正确识别这些发现并做出适当反应。
