【摘要】：目的：分析老年科65歲以上老年患者的頭痛患病情況，并比較不同類型頭痛的臨床特點(diǎn)、其診斷和治療現(xiàn)狀，以期為老年人群頭痛的研究提供一定的參考價(jià)值。 方法：收集2012年10月~2014年~2月之間連續(xù)在老年科住院的患者。根據(jù)入組標(biāo)準(zhǔn)，對所有符合入組標(biāo)準(zhǔn)的患者進(jìn)行頭痛篩查，訴過去一年里至少有過一次引起過自己注意的頭痛的病人進(jìn)行頭痛評估。頭痛評估數(shù)據(jù)采集使用自制頭痛量表。頭痛診斷采用ICHD-II標(biāo)準(zhǔn)及其2006修訂版，頭痛程度的評估采用疼痛視覺模擬評分（VAS）。 結(jié)果：共對529名患者進(jìn)行了評估，其中共有134（25.3%）名患者訴在過去一年里至少有過一次頭痛。所有頭痛患者中，26名（19.5%）診斷為偏頭痛，64名（48%）診斷為緊張性頭痛，49名（34.6%）為其他類型頭痛。頭痛的臨床特點(diǎn)：分別有73.1%偏頭痛和84.7%緊張性頭痛為雙側(cè)頭痛。偏頭痛和其他類型頭痛最常見疼痛性質(zhì)的均為搏動(dòng)性痛（61.5%37.8%），緊張性頭痛最常見的疼痛性質(zhì)為脹痛（52.4%）。偏頭痛患者中62.5%患者在頭痛發(fā)作期間伴有畏光、畏聲，23.1%患者伴有惡心，11.5%患者伴有嘔吐。緊張性頭痛患者中16%患者伴有畏聲，其他類型的頭痛伴隨癥狀較少見。疼痛程度以偏頭痛最重，，其次是其他類型頭痛（p0.05）。偏頭痛的頭痛發(fā)作頻率明顯少于緊張性頭痛和其他類型頭痛（p0.05）。治療現(xiàn)狀：77.0%偏頭痛患者，57.2%緊張性頭痛患者及51.0%其他類型頭痛患者在過去一年里曾因頭痛就診過，其中23.1%偏頭痛患者，6.5%緊張性頭痛患者，16.2%其他類型頭痛患者得到過確切診斷。所有頭痛患者中有61.9%患者在過去一年里因頭痛使用過藥物，復(fù)合型止痛藥、中成藥、非甾類藥物是最常用三類藥物，僅有8.2%的患者為遵醫(yī)囑服藥。 結(jié)論：老年科65歲人群中頭痛患病率約25%，緊張性頭痛是最常見的頭痛類型，其次為偏頭痛。頭痛偏頭痛在老年人中主要表現(xiàn)為雙側(cè)的、中度、搏動(dòng)性頭痛，畏光、畏聲是常見的伴隨癥狀，惡心、嘔吐較少見。緊張性頭痛的臨床特點(diǎn)主要表現(xiàn)為雙側(cè)的、輕-中度、非搏動(dòng)性頭痛，伴隨癥狀較少見。 超過三分之二的頭痛患者曾因頭痛就診過，這些患者中僅有少量患者得到過確切診斷。約60%頭痛患者使用過急性止痛藥，不到10%患者在醫(yī)生指導(dǎo)下使用藥物。復(fù)合型止痛藥、非甾類消炎藥、中成藥是最常使用的三類止痛藥。
[Abstract]:Objective: to analyze the prevalence of headache in elderly patients over 65 years of age in geriatrics, and to compare the clinical characteristics, diagnosis and treatment of different types of headache, in order to provide some reference value for the study of headache in elderly people. Methods: the patients in geriatric department from October 2012 to February 2014 were collected. According to the admission criteria, all patients who met the admission criteria were screened for headache, and headache assessments were performed on patients who had headaches that had attracted their attention at least once in the past year. Headache assessment data were collected using a self-made headache scale. The ICHD-II standard and its 2006 revised edition were used to diagnose headache. The headache degree was assessed by (VAS). Results: a total of 529 patients were assessed, 134 (25.3%) of whom reported having at least one headache in the past year. Among all the headache patients, 26 (19.5%) were diagnosed as migraine and 64 (48%) as tension headache and 49 (34.6%) as other types of headache. Clinical features of headache: 73.1% migraine and 84.7% tension headache were bilateral headache. The most common pain of migraine and other types of headache was pulsatile pain (61.57.8%), the most common pain of tension headache was flatulence (52.4%). 62.5% of migraine patients had photophobia during headache attack, and 23.1% of them were accompanied with nausea and vomiting. Sixteen per cent of patients with tension headache were accompanied by fear of sound, while other types of headache accompanied by symptoms were less common. The most severe pain was migraine, followed by other types of headache (p0.05). The frequency of migraine attack was significantly less than that of tension headache and other types of headache (p0.05). 77.0% migraine patients 57.2% tension headache patients and 51.0% other headache patients have been treated with headache in the past year, of which 23.1% migraine patients or 6.5% tension headache patients or 16.2% other types of headache patients have been accurately diagnosed. In the past year, 61.9% of all headache patients had used drugs, compound painkillers, Chinese patent medicines and non-steroidal drugs were the most commonly used three kinds of drugs, only 8.2% of the patients were prescribed by doctors. Conclusion: the prevalence of headache is about 25% in 65 years old people in geriatrics. Tension headache is the most common type of headache, followed by migraine. Headache and migraine are mainly bilateral, moderate, pulsatile headache, photophobia and fear of sound are common accompanying symptoms in the elderly, nausea and vomiting are rare. The clinical features of tension headache are bilateral, mild to moderate, non-pulsatile headache, accompanied by rare symptoms. More than 2/3 headache patients have had a headache visit, and only a small number of these patients have had a definite diagnosis. About 60% of headache patients have used acute pain relievers, and less than 10% have taken medications under the guidance of doctors. Compound analgesics, non-steroidal anti-inflammatory drugs, Chinese patent medicine is the most commonly used three types of painkillers.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R747.2

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