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生长痛

Author
Thomas JA Lehman, MD
Section Editor
Marisa Klein-Gitelman, MD, MPH
Deputy Editor
Elizabeth TePas, MD, MS
Translators
单延春, 副主任医师

引言

父母、儿童及医护人员无法解释的反复自限性肢体疼痛通常被称为“生长痛”。1823年的医学文献首次描述了这种疼痛[1]。之后的文献将这种疼痛归咎于“风湿病”，该词在当时与风湿热同义[2-7]。有文献称生长痛与消化和睡眠紊乱、关节松弛、姿势不正和慢性感染有关[3,8,9]。到20世纪30和40年代，生长痛已与风湿热及其他病理情况区分开[5-7]。这种区分现在仍然是评估儿童反复肢体疼痛的重点。

生长痛是良性的，通常在初次发作后的1年或2年内消失，必须与需要另外治疗的病理性疼痛原因区分开(表 1)。

本文将总结儿童生长痛的流行病学、病因、临床表现、评估及处理。儿童关节疼痛和跛行的评估将单独讨论。 (参见“儿童跛行的诊断方法”和“儿童关节疼痛和/或肿胀的评估”)

定义

生长痛没有一致的定义，因此没有哪一种纳入或排除标准普遍适用于儿童生长痛相关的研究。关键考虑点在于，临床医生不要把“生长痛”看作一个很重要的可能需要采取干预措施的问题。

因此，最好把“生长痛”限定为儿童在夜间或小睡时痛醒但又无任何骨骼肌肉异常表现。相反，在活动时伴发不明原因关节痛的儿童需要进一步检查，而典型“生长痛”的儿童可能不需要。

           

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Literature review current through: 2017-06 . | This topic last updated: 2016-02-24.
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