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利用光谱光度法评估儿童瘀伤的年龄:通过测量瘀伤颜色的变化来判断儿童是否受到身体虐待。

Spectrophotometric evaluation of the age of bruises in children: measuring changes in bruise color as an indicator of child physical abuse.

机构信息

Department of Forensic Sciences, Akita University Graduate School of Medicine, Akita, Japan.

出版信息

Tohoku J Exp Med. 2010 Feb;220(2):171-5. doi: 10.1620/tjem.220.171.

Abstract

Physical abuse of children is a severe social problem and is usually identified by the presence of bruises of various ages. The visual appearance of bruises is widely used to identify victims of abuse. Therefore, to objectively evaluate the age of bruises, we used a spectrophotometer to examine 86 bruises that occurred accidentally in healthy child volunteers, with consent from appropriate guardians. The bruise color was measured using a spectrophotometer and plotted using the CIE-Lab* color system, a method that expresses color numerically. The differences [Delta] in L* (lightness), a* (red and green content) and b* (yellow and blue content) color values relative to neighboring healthy/unbruised skin were measured for 7-10 days until the bruise disappeared. A characteristic pattern was observed in 21 bruises; DeltaL* increased from the negative peak and returned to baseline, Deltaa* decreased from the positive peak to baseline, and Deltab* increased above baseline and then slowly returned to baseline. The pattern of these color changes could be classified into three phases according to the time between bruising and the peak values for DeltaL* (negative peak, 38.9 +/- 19.5 hours), Deltaa* (positive peak, 37.6 +/- 21.7 hours), and Deltab* (negative and positive peak, 43.5 +/- 18.7 and 132.6 +/- 40.4 hours). Thus, spectrophotometric measurement of the color of bruises is helpful to estimate the approximate age of bruises and to distinguish between old and new bruises. This objective method could be introduced to clinical practice and social care to evaluate possible cases of child abuse.

摘要

儿童身体虐待是一个严重的社会问题,通常通过存在不同时期的瘀伤来识别。瘀伤的外观广泛用于识别虐待受害者。因此,为了客观评估瘀伤的年龄,我们使用分光光度计检查了 86 例在健康儿童志愿者中意外发生的瘀伤,这些志愿者得到了适当监护人的同意。使用分光光度计测量瘀伤颜色,并使用 CIE-Lab颜色系统绘制,这是一种用数值表示颜色的方法。测量瘀伤消失前 7-10 天内相对相邻健康/未瘀伤皮肤的 L(亮度)、a*(红色和绿色含量)和 b*(黄色和蓝色含量)颜色值的差异[Delta]。观察到 21 个瘀伤中存在特征性模式;DeltaL从负峰增加并返回基线,Deltaa从正峰下降至基线,Deltab超过基线增加,然后缓慢返回基线。根据瘀伤与 DeltaL(负峰,38.9 +/- 19.5 小时)、Deltaa*(正峰,37.6 +/- 21.7 小时)和 Deltab*(负峰和正峰,43.5 +/- 18.7 和 132.6 +/- 40.4 小时)峰值之间的时间,这些颜色变化模式可分为三个阶段。因此,对瘀伤颜色的分光光度测量有助于估计瘀伤的大致年龄,并区分新旧瘀伤。这种客观方法可以引入临床实践和社会关怀,以评估可能的儿童虐待案例。

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