Antoniazzi Ana L, Bigal Marcelo E, Bordini Carlos A, Speciali José G
Departamento de Neurologia, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Arq Neuropsiquiatr. 2002 Sep;60(3-A):614-8.
A growing number of patients have been undergoing dialysis procedures all around the world. Around 70% of the patients receiving dialysis treatment complain about headaches. In spite of this, headache is not well studied in this group of patients. The aims of this study are: to evaluate possible triggering factors related to hemodialysis headache and to evaluate the analgesic treatments used under this situation. We prospectively studied 50 patients with chronic renal failure attending to three dialysis services from the town of Ribeirão Preto, State of São Paulo, Brazil, from January 1998 to December 1999. All of them presented headaches strictly related to the hemodialysis sessions. Headache occurred mainly in the second half of the hemodialysis (86%). Arterial hypertension (38%), arterial hypotension (12%) and changes in the weight during the hemodialysis sessions (6%) were the most consistently triggering situations. In 28% of the cases no factors were identified. Dipyrone was, by far (56%), the most frequently analgesic used. Despite being so common it noteworthy how scarce are studies in literature concerning headaches in patients with chronic renal failure. These patients, besides having to bear the burden of living with a painful and boring procedure to keep them alive, many of them have the additional burden, to live with a headache in most of the sessions. The identification of possible triggering factors and further evaluations of the treatment might increase our knowledge and contribute to reduce the burden of the headaches in patients with chronic renal failure.
全球范围内，接受透析治疗的患者数量日益增多。约70%接受透析治疗的患者抱怨头痛。尽管如此，针对这组患者的头痛情况研究并不充分。本研究的目的是：评估与血液透析头痛相关的可能触发因素，并评估在这种情况下使用的止痛治疗方法。1998年1月至1999年12月，我们对来自巴西圣保罗州里贝朗普雷图市三家透析中心的50例慢性肾衰竭患者进行了前瞻性研究。他们所有人的头痛都与血液透析 sessions 严格相关。头痛主要发生在血液透析的后半段（86%）。动脉高血压（38%）、动脉低血压（12%）以及血液透析 sessions 期间体重的变化（6%）是最常见的触发情况。在28%的病例中未发现触发因素。安乃近是迄今为止使用最频繁的止痛药（56%）。尽管这种情况很常见，但值得注意的是，关于慢性肾衰竭患者头痛的文献研究却非常稀少。这些患者不仅要承受维持生命的痛苦且枯燥的治疗过程，许多人在大多数治疗 sessions 中还要额外承受头痛的困扰。确定可能的触发因素并进一步评估治疗方法，可能会增加我们的认识，并有助于减轻慢性肾衰竭患者头痛的负担。
