Geisinger Wyoming Valley, Department of Neurology, Wilkes-Barre, PA, USA.
Headache. 2011 Feb;51(2):191-200. doi: 10.1111/j.1526-4610.2010.01806.x. Epub 2010 Nov 16.
To present results from the United States Cluster Headache Survey concerning the use of inhaled oxygen as acute treatment for cluster headache (CH).
Several small clinic and community-based investigations have indicated that more than 50% of CH patients have never used oxygen for the treatment of their headaches. This statistic is alarming and the reasons why they have not tried oxygen have not been determined.
The United States Cluster Headache Survey is the largest study ever completed looking at CH sufferers living in the United States. The total survey consisted of 187 multiple choice questions, 84 questions dealt with oxygen use, efficacy and economics. The survey was placed on a website from October to December 2008.
A total of 1134 individuals completed the survey (816 male, 318 female). Among them 868 patients had episodic CH while 266 had chronic CH. Ninety-three percent of survey responders were aware of oxygen as a CH therapy; however, 34% had never tried oxygen. Forty-four percent of patients had to suggest oxygen to their physicians to get prescribed. Twelve percent of physicians refused to prescribe oxygen. Fifty percent using oxygen never received training on proper use. Forty-five percent had to find their own source for oxygen. On prescriptions only 45% specified flow rate, 50% stated CH as diagnosis and 28% indicated mask type. Seventy percent of the surveyed population felt oxygen was effective but only 25% was presently using oxygen. Potential reasons for this finding include: oxygen is slow to onset; prescribed oxygen flow rates are too low for efficacy and most CH patients need to raise flow rates during attacks to achieve response. The efficacy of oxygen does not vary by the age of the patient, gender, the number of CH attacks per day, and smoking history. Episodic CH responds better and faster to inhaled oxygen than chronic CH. Oxygen plus a triptan may be more efficacious and faster at aborting a CH than a triptan alone. Sixteen percent of CH patients state that oxygen is unaffordable while 12% are getting welder grade oxygen because of costs of medical grade oxygen, and this form of oxygen could be potentially dangerous to the individual user.
Oxygen is underutilized by CH patients living in the United States. Current recommended oxygen treatment regime is not meeting the needs of many CH patients. Prescribed oxygen flow rates are too low for efficacy. Oxygen can be expensive and very difficult to obtain. Physicians need to be better educated on the use of inhaled oxygen for CH.
呈现美国丛集性头痛调查的结果，该调查涉及使用吸入氧气作为丛集性头痛（CH）的急性治疗方法。
一些小型诊所和社区研究表明，超过 50%的 CH 患者从未使用过氧气来治疗头痛。这一统计数据令人震惊，而且尚未确定他们为何未尝试使用氧气。
美国丛集性头痛调查是有史以来针对居住在美国的丛集性头痛患者完成的最大规模研究。该总调查共包含 187 个多项选择题，其中 84 个问题涉及氧气使用、疗效和经济学。该调查于 2008 年 10 月至 12 月在一个网站上进行。
共有 1134 人完成了调查（816 名男性，318 名女性）。其中 868 名患者患有发作性 CH，266 名患者患有慢性 CH。93%的调查应答者知道氧气是 CH 治疗方法之一；然而，34%的患者从未尝试过氧气。44%的患者不得不向医生建议使用氧气以获得处方。12%的医生拒绝开具氧气处方。50%使用氧气的患者从未接受过正确使用氧气的培训。45%的患者不得不自行寻找氧气源。仅在处方中，45%指定了流速，50%指出 CH 作为诊断，28%表明面罩类型。70%的调查人群认为氧气有效，但目前只有 25%的人在使用氧气。造成这种情况的潜在原因包括：氧气起效缓慢；规定的氧气流速对于疗效来说太低，大多数 CH 患者在发作时需要提高流速才能产生反应。氧气的疗效不受患者年龄、性别、每日 CH 发作次数和吸烟史的影响。发作性 CH 比慢性 CH 对吸入氧气的反应更快、更有效。氧气加曲普坦可能比单独使用曲普坦更有效、更快地终止 CH 发作。16%的 CH 患者表示氧气负担不起，而 12%的患者因医用级氧气的费用而获得焊工级氧气，因为这种形式的氧气对个人用户可能存在潜在危险。
生活在美国的 CH 患者对氧气的使用不足。目前推荐的氧气治疗方案不能满足许多 CH 患者的需求。规定的氧气流速对于疗效来说太低。氧气可能很贵，而且很难获得。医生需要更好地接受关于 CH 患者使用吸入氧气的教育。
