儿童间隔综合征的早期诊断与治疗

通过对患间隔综合征的３１例患儿复查，总结如何正确作出早期诊断和治疗的经验。３１例患儿中，上肢病变１６例，其中９例为肱骨髁上骨折（５６％），下肢病变１５例，其中７例为胫腓骨骨折（４０％）。２５例行筋膜减张术，１７例获得随访，平均随访时间为２８个月，１４例肢体功能恢复（８２％）。治疗成功的关键在于早期诊断和治疗，彻底的筋膜减张是预防神经、肌肉坏死唯一有效的方法。临床诊断间隔综合征的五大要点：疼痛是最早最常见的症状，感觉障碍是很早出现而易被忽视的体征，疼痛消失和麻痹是晚期标志，被动牵拉试验阳性是手术适应证，但不能作为唯一的确诊指标。

Early diagnosis and Treatment for Compartment Syndrome in Children

Thirty-one cases,of compartment syndrome were reviewed.In 16 cases of upper limb involvement,9 cases(56%)resulted from supracondylar fracture of the humerus.In 15 cases of lower limb involvement,7(40%)resulted from fractures,of the titrla and fibula. Of them,25 cases underwent fasciotomy,17 cases were followed up for an average of 28 months.Successful results were obtained in 14(82%).It seems that early diagnosis and treatment are very important for good prognosis.Thorough fasciotomy is the only effective method to prevent nerve and muscle necrcois.The authors suggest the significance of 5P signs:pain is the earliest and most common symptom,paresthesia appears early but is easily neglected,paralysis and painlessness are the late signs;pain aggravated by passive extension with a definite diagnosis is an indication of operation.