DeLago Cynthia, Finkel Martin A, Clarke Claudia, Deblinger Esther
Albert Einstein Medical Center Department of Pediatrics, Philadelphia, PA 19141, USA.
J Pediatr Adolesc Gynecol. 2012 Oct;25(5):334-9. doi: 10.1016/j.jpag.2012.06.003.
Sexually abused (SA) girls report urogenital symptoms temporally related to inappropriate genital contact. Since girls also experience symptoms following genital irritant exposure and mostly all girls are exposed to genital irritants, we describe overall symptoms reported by girls that disclosed SA compared to those that did not and we compare how girls describe symptoms following a specific episode of contact SA vs a genital irritant exposure.
Cross-sectional study. Parents/girls interviewed; medical records reviewed.
Five to 12-year-old premenarchal girls/parents.
An urban and a suburban pediatric practice; a regional treatment center for child abuse.
Prevalence of histories of urogenital symptoms in SA girls compared to girls attending well-child exams (controls); girls' description of urogenital symptoms following specific episodes of contact SA compared to specific episodes of genital irritant exposure.
More parents/girls in SA group reported prior urogenital symptoms. Most SA girls said past symptoms were caused by inappropriate genital touching; most control girls could not identify causes for prior symptoms. Girls' responses following specific irritant exposures: 76% SA vs 24% control girls used negative terms to describe how it felt, 69% SA vs 6% control girls said it bothered her body and her feelings, and 33% SA vs 12% control girls described experiencing dysuria afterwards (all ps < 0.05).
Girls can relate urogenital symptoms to specific genital contacts; more SA girls reported unpleasant symptoms with an emotional component. A skilled medical history can help differentiate these conditions and diagnose sexual abuse with greater certainty.
遭受性虐待（SA）的女孩报告有与不当生殖器接触在时间上相关的泌尿生殖系统症状。由于女孩在接触生殖器刺激物后也会出现症状，且几乎所有女孩都接触过生殖器刺激物，因此我们描述了披露遭受性虐待的女孩与未披露的女孩报告的总体症状，并比较了女孩如何描述特定接触性性虐待事件与生殖器刺激物暴露后的症状。
横断面研究。对父母/女孩进行访谈；查阅病历。
5至12岁的青春期前女孩/父母。
一个城市和一个郊区的儿科诊所；一个儿童虐待区域治疗中心。
与参加健康儿童检查的女孩（对照组）相比，遭受性虐待女孩的泌尿生殖系统症状病史患病率；与特定生殖器刺激物暴露事件相比，女孩对特定接触性性虐待事件后泌尿生殖系统症状的描述。
性虐待组中更多的父母/女孩报告有先前的泌尿生殖系统症状。大多数遭受性虐待的女孩表示过去的症状是由不当的生殖器触摸引起的；大多数对照女孩无法确定先前症状的原因。女孩在接触特定刺激物后的反应：76%的遭受性虐待女孩与24%的对照女孩使用负面词汇描述感受，69%的遭受性虐待女孩与6%的对照女孩表示这困扰了她的身体和情绪，33%的遭受性虐待女孩与12%的对照女孩描述之后出现排尿困难（所有p值<0.05）。
女孩可以将泌尿生殖系统症状与特定的生殖器接触联系起来；更多遭受性虐待的女孩报告有带有情感成分的不适症状。详细的病史有助于区分这些情况并更准确地诊断性虐待。
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