Sathirareuangchai Sakda, Phobtrakul Rattana, Phetsangharn Ladda, Srisopa Kamontip, Petchpunya Saowarat
Department of Forensic Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Department of Forensic Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
J Forensic Leg Med. 2015 Oct;35:69-72. doi: 10.1016/j.jflm.2015.08.003. Epub 2015 Aug 13.
Specimen collection from sexual assault victims is an essential part of practice in forensic medicine. Semen analysis is a forensic test used to confirm sexual contact. Two methods of specimen collection were compared in this study: the genital swab and bedside slide smear.
A retrospective chart review was performed in the Division of Clinical Forensic Medicine, Siriraj Hospital, Thailand. Data were collected on microscopic spermatozoa detection in the external and internal genitalia, the time interval from assault to visit, and the history of condom use and genital cleansing. McNemar's test was used for comparison between the genital swab and bedside slide smear techniques.
In total, 724 case files from 2009 to 2013 were reviewed. The genital swab technique yielded a higher detection rate than did the bedside slide smear technique in both the external genitalia (37.0% vs. 31.8%, respectively) and internal genitalia (40.8% vs. 34.1%, respectively). Collection of a genital swab only missed positive cases in 4%-6% of negative swabs. When considering both the external and internal genitalia, the genital swab still yielded a higher rate of positive results than did the slide smear (45.9% vs. 39.0%, respectively). Examination of the victim within the first 3 days produced the highest spermatozoa detection rate (46.3%).
The genital swab is the preferred specimen collection method for spermatozoa detection in adult sexual assault victims. However, collection of both a swab and slide specimen may be considered in some cases. Collection of specimens later than 3 days after the assault greatly decreases the rate of spermatozoa detection.
从性侵犯受害者身上采集标本是法医学实践的重要组成部分。精液分析是用于确认性接触的法医检验。本研究比较了两种标本采集方法：生殖器拭子法和床边玻片涂片法。
对泰国诗里拉吉医院临床法医学科进行了回顾性病历审查。收集了关于外生殖器和内生殖器中显微镜下精子检测、从性侵到就诊的时间间隔以及避孕套使用和生殖器清洁史的数据。采用McNemar检验比较生殖器拭子法和床边玻片涂片法。
共审查了2009年至2013年的724份病例档案。生殖器拭子法在外生殖器（分别为37.0%和31.8%）和内生殖器（分别为40.8%和34.1%）中的检测率均高于床边玻片涂片法。仅采集生殖器拭子在4%-6%的阴性拭子中遗漏了阳性病例。综合考虑外生殖器和内生殖器，生殖器拭子的阳性结果率仍高于玻片涂片（分别为45.9%和39.0%）。在性侵后的前3天内对受害者进行检查产生的精子检测率最高（46.3%）。
生殖器拭子是成年性侵犯受害者精子检测的首选标本采集方法。然而，在某些情况下可考虑同时采集拭子和玻片标本。在性侵3天后采集标本会大大降低精子检测率。
