兒童虐待：三病例報告

兒童虐待(child abuse)其定義為懲罰兒童導致其身體或心理永久傷害，甚至死亡的狀態稱之。病例1是位7歲男童，由於考試成績不理想，被其母親毆打，導致腹脹與腹痛現象，腹部超音波與電腦斷層掃描皆證實有腹水及胰臟體部有一個3×3公分假性囊腫，目前患童仍住院治療中。病例2是位4歲女童，因過於頑皮被其繼父摔倒在籐椅上，呈現半昏迷狀態，頭部電腦斷層掃描顯示左側額顳部有硬腦膜下出血及左腦水腫壓迫左側腦室，並使中線向右位移，5天後患童不幸死亡。病例3是位2歲女童，被其褓母毆打產生頭痛，嘔吐和抽搐現象，頭部電腦斷層掃描顯示右側明顯腦水腫且中線向左位移，不幸於28天後死亡。精神因素可能是造成兒童虐待最重要的原因，但我們對於這些因素的認識有限，因為這些施虐者並不侷限於精神特異者，往往許多為正常成人，甚至於兒童的親生父母親皆會對兒童造成虐待。很清楚地，所有醫師必須非常熟悉如何處理疑似兒童虐待的病例。所以，本篇之目的，乃提醒兒科醫師應將兒童虐待的問題更深入了解，共同努力來解決此種不幸的疾病。

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並列摘要

Child abuse, a clinical condition in young children who have received serious physical abuse, is a frequent cause of permanent injury or death. The first case is a 7-year-old boy suffering from abdominal distension and pain for 3 days. He was beaten by his mother as a result of inadequately learning his lessions. Sonogram and CT of the abdomen showed massive ascites and a pseudo-cyst of the pancreative body about 3 × 3 cm in diameter. The second case is a 4-year-old girl who developed a semicomatous state after her father impulsively struck her with a chair. CT of the brain revealed subdural hematoma over the left fronto-temporal region and midline shift to the right. She expired 5 days later. The third case, a 2-year-old girl, suffered from headache, seizure, vomiting and general malaise. CT of the brain showed severe brain swelling over the right side and midline shift to the left. She expired 1 month later. Psychiatroc factors are probably of prime importance in the pathogenesis of the disorder, but our knowledge of these factors is limited. Parents who inflict abuse on children do not necessarily have psychopathic or sociopathic personalities or come from borderline socioeconomic groups, although most published cases fall into one of these categories. It is clearly the responsibility of all physicians serving children to be aware of, to recognize, and to properly manage any child who has been the victim of abuse.

並列關鍵字

child abuse

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兒童虐待：三病例報告

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