儿童虐待性颅脑外伤研究进展

Epidemiological Characteristics of Abusive Head Trauma in Children

虐待性颅脑外伤(AHT)是一种严重的虐待形式,是所有类型的儿童虐待中最严重的致命伤害,占儿童虐待死亡人数的30.00%。AHT常见于1岁以内儿童,其发病率在1~4月龄大时达到峰值,平均患病年龄为5月龄。AHT的发病率为(12.7~38.8)/10万,病死率为20.00%~30.00%。患者常患有认知、行为、智力等发育障碍。AHT在父母年龄小、教育程度低、产后抑郁、滥用药物、酗酒、有精神疾病等特征人群中多发。父母或其他看护者的暴力摇晃是AHT发生的主要原因,而婴儿的哭泣是引发看护者摇晃行为的常见诱因,预防AHT发生的重点是对看护者开展摇晃知识教育。本文就AHT的流行特征、影响因素、临床表现、诊断、治疗、预后及预防策略和措施进行综述,以供相关人员参考。

Abusive head trauma(AHT)is a serious form of abuse to children.It is also the most serious fatal injury in all types of child abuses,accounting for approximately 30.00%of the deaths of child maltreatments.AHT usually occurs during the first year of life and reaches its peak at 1~4 months old,with the average age of 5 months.The incidences of AHT ranged from 12.7 to 38.8 per 100,000 people,and the estimated fatality rates ranged from 20.00%to 30.00%.Survivors often suffer from cognitive,behavioral,intellectual and other developmental disorders.Studies have shown that AHTs were more common in children when parents were young,and/or had low education,postpartum depression,substance abuse,alcohol abuse,mental illness.etc.Violent shakings by parents or other caregivers were the most commonly reported cause of AHT.Crying was a common inducer for shaking by caregivers.Therefore,a key point of preventing AHT is to educate caregivers on hazards from shaking.In conclusion,our review identified epidemiological characteristics,influencing factors,clinical manifestations,diagnosis,treatment,prognosis and prevention of AHT.