Sirotnak A P, Krugman R D
University of Colorado Health Sciences Center, USA.
Del Med J. 1997 Jul;69(7):335-43.
Now, more than ever, physicians must be willing to suspect child abuse and report their concerns. New information from the past decade warns us that reports of violence against children continue to increase. We are learning that MRI imaging of the head may, in some cases, help date subdural hematomas, but long-term developmental follow-up studies of "shaken" infants are lacking. Intentional thoracic and abdominal injuries carry a high mortality. Finally, new information in the field of child abuse-in particular, physical abuse-is slow to come. Lack of funding for basic medical child abuse research and lack of trained researchers in the field are the two most important barriers. Preventive intervention at the community and family level needs to be supported by both the pediatrician and the local and national government leaders. As the U.S. Advisory Board on Child Abuse and Neglect says, "We need to make it as easy for parents to pick up the telephone and get help before they abuse their child as it is now for their neighbor or physician to pick up the telephone and report them after it has happened." Child health practitioners may be in the best position to implement such a policy.
如今，医生比以往任何时候都更必须愿意怀疑存在虐待儿童的情况并报告他们所关切的问题。过去十年的新信息警示我们，针对儿童暴力行为的报告持续增加。我们了解到，头部的磁共振成像（MRI）在某些情况下可能有助于确定硬膜下血肿的时间，但对于“受摇晃”婴儿的长期发育随访研究却很缺乏。故意造成的胸部和腹部损伤死亡率很高。最后，虐待儿童领域，尤其是身体虐待方面的新信息来得很慢。基础儿童虐待医学研究资金不足以及该领域缺乏训练有素的研究人员是两个最重要的障碍。社区和家庭层面的预防性干预需要得到儿科医生以及地方和国家政府领导人的支持。正如美国虐待和忽视儿童问题咨询委员会所说：“我们需要让父母在虐待孩子之前拿起电话寻求帮助变得像现在他们的邻居或医生在事情发生后拿起电话举报他们一样容易。”儿童健康从业者可能最有能力实施这样一项政策。
