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一种用于识别和诊断儿童非意外创伤的多专科方法。

A Multispecialty Approach to the Identification and Diagnosis of Nonaccidental Trauma in Children.

作者信息

Manan Muhammad Romail, Rahman Sara, Komer Leah, Manan Hamna, Iftikhar Saadia

机构信息

Medicine, Services Institute of Medical Sciences, Lahore, PAK.

Basic Sciences, Services Institute of Medical Sciences, Lahore, PAK.

出版信息

Cureus. 2022 Jul 26;14(7):e27276. doi: 10.7759/cureus.27276. eCollection 2022 Jul.

DOI:10.7759/cureus.27276
PMID:36039273
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9404682/
Abstract

Child abuse is a preventable phenomenon of considerable concern resulting in significant child mortality and morbidity. We analyze various abuse lesions such as radiological (visceral and skeletal lesions and those associated with head trauma) and cutaneous (burns, bruises, bites, etc.) to enhance streamlined identification of injuries in cases of physical child abuse. For effective results, it is essential to remain mindful of all background factors, such as the caregiver setting and the prevalence of child maltreatment in the concerned community while acknowledging the possibility of natural causes (genetic diseases such as osteogenesis imperfecta and hemophilia, or acquired abnormalities) that can mimic NAT and cause confusion in diagnosis and treatment. The margin of error in cases of abuse is negligible, therefore, making its diagnosis a momentous as well as challenging clinical task. An ineffective diagnosis can have detrimental emotional consequences for the family and may even expose the child to future potentially fatal episodes of abuse. Hence, there is a need to direct special focus on the importance of accurate history taking and immediate, responsible reporting to authorities, as well as to child protective services. Therefore, considering the multifactorial approach this subject requires, this review aims to delve into prevalence statistics, various risk factors, and their effect on psychological health to offer a near-complete regulation to ensure an effective understanding of NAT on part of doctors, social workers, and other relevant authorities.

摘要

虐待儿童是一种可预防但令人相当担忧的现象,会导致儿童出现严重的死亡率和发病率。我们分析各种虐待造成的损伤,如放射学损伤(内脏和骨骼损伤以及与头部创伤相关的损伤)和皮肤损伤(烧伤、瘀伤、咬伤等),以加强对身体虐待儿童案件中损伤的精准识别。为取得有效结果,必须牢记所有背景因素,如照顾者情况以及相关社区中儿童受虐待的普遍程度,同时要认识到自然原因(如成骨不全症和血友病等遗传疾病,或后天异常)可能会模仿非意外伤害并在诊断和治疗中造成混淆。虐待案件中的误差范围可忽略不计,因此,对其进行诊断是一项重大且具有挑战性的临床任务。诊断无效可能会给家庭带来有害的情感后果,甚至可能使儿童在未来面临潜在致命的虐待事件。因此,需要特别关注准确记录病史以及立即、负责地向当局和儿童保护服务机构报告的重要性。鉴于该主题需要多因素方法,本综述旨在深入探讨患病率统计数据、各种风险因素及其对心理健康的影响,以提供近乎完整的规范,确保医生、社会工作者和其他相关当局能有效理解非意外伤害。

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