| 330例颈源性头痛临床特征回顾性分析 |
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Received:December 23, 2009
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| 期刊信息：《中国骨伤》2010年23卷，第3期，第208-211页 |
| DOI：10.3969/j.issn.1003-0034.2010.03.019 |
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目的：通过颈源性头痛患者临床特征的总结，进一步完善诊断标准。
方法：对2008年10月至2009年6月以头痛为第一主诉的448例患者按照改进的颈源性头痛诊断标准进行筛选，符合诊断标准者399例，其中330例资料完整，男97例，女233例；年龄14～76岁，平均46.1岁；病程0.33～50年，平均13.4年。详细记录患者的年龄、性别、职业、头痛特点，查找压痛点位置及出现放散痛的范围等，并进行分析归纳。
结果：颈源性头痛占头痛患者的比例为89.1%(399/448);男女之比为1∶2.4;78.8%(260例)的患者年龄在21～60岁，尤以41～50岁居多；97.3%(321例)的患者头痛呈阵发性，只有2.7%(9例)的患者呈持续性。多数患者的头痛性质呈胀痛(181例，占54.8%)或跳痛(135例，占40.9%),这两种性质的疼痛可能并存，其他类型的疼痛均为少数。多数患者的头痛部位为枕部、头顶、颞部，约1/3可波及到前额、眼眶、或眼球，极少数波及到耳、鼻翼及鼻梁等处。76.4%(252例)的患者为全头痛或双侧头痛，只有12.1%(40例)为单侧头痛。几乎所有患者均有枕神经卡压表现，其中73.3%(242例)为枕大、小神经混合受累；82.7%(273例)的患者枕部受到按压时出现向头部的放散痛。
结论：①颈源性头痛占头痛患者比例较高；②现有诊断标准尚不完善，有必要改进；③按压颈枕部特定位置出现放散痛是其重要的诊断依据。 |
| [关键词]:头痛 颈椎 诊断 疼痛测定 |
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| Study on diagnostic criteria of cervicogenic headache: a report of retrospective analysis on 330 cases |
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Abstract:
Objective: To improve the diagnostic criteria of cervicogenic headache by summary the clinical features of cervicogenic headache in patients.
Methods: Among 448 patients with the chief complaint of headache for the first visit from October 2008 to June 2009,399 cases meet the diagnostic criteria,330 cases were diagnosed as cervicogenic headache. There were 97 males and 233 females,ranging in age from 14 to 76 years,with an average of 46.1 years. The duration of the disease ranged from 0.33 to 50 years,with an average of 13.4 years. The gender,age,occupation,headache characteristics of the patients were recorded,and the tenderness point position and the range of diffuse pain were summarized for analysis.
Results: There were 89.1% headache patients were cervicogenic headache,the male to female ratio was 1∶2.4,78.8%(260 cases) patients aged 21 to 60 years old,especially those 41 to 50 years old was the majority. There were 97.3%(321 cases) patients with paroxysmal headache,and only 2.7%(9 cases) patients had persistent headache. Majority patients had swelling pain(181 cases,accounting for 54.8%) or pulsatile pain(135 cases,accounting for 40.9 %). Above two types pain may coexist,and other types were few. The position of headache concentrated at occiput,corona capitis and tempus,and could spread to the forehead,fossa orbitalis,or eye(about 1/3 patiens),very few spread to the ears,nasal wing or bridge of the nose,etc. There were 76.4%(252 cases) patients with full or bilateral headache, and only 12.1%(40 cases) with unilateral headache. Almost all the patients had symptoms of occipital nerve entrapment,among which about 73.3%(242 cases) patients had greater and lesser occipital large involved. There were 82.7%(273 cases) patients showing radiating pain by pressing the special point of occiput.
Conclusion: ①Cervicogenic headache patients accounted for a higher proportion;②The existing diagnostic criteria is not perfect,and need to be improved;③Radiating pain occurred when pressing the specific location is an important diagnosis criteria. |
| KEYWORDS:Headache Cervical vertebrae Diagnosis Pain measurement |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李石良,韩峰,张辰宇.330例颈源性头痛临床特征回顾性分析[J].中国骨伤,2010,23(3):208~211 |
| 英文格式: | LI Shi-liang,HAN Feng,ZHANG Chen-yu.Study on diagnostic criteria of cervicogenic headache: a report of retrospective analysis on 330 cases[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(3):208~211 |
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