Barton C W
Department of Medicine, Medical Center, University of California, San Francisco 94143-0208.
Headache. 1994 Feb;34(2):91-4. doi: 10.1111/j.1526-4610.1994.hed3402091.x.
Patients with headache represent a common diagnostic and treatment challenge for health care providers in the emergency department. The therapeutic options continue to grow, yet many studies imply that narcotics continue to be a frequently chosen treatment. In this retrospective cross-sectional survey, the evaluation and treatment patterns of patients presenting to an academic medical center emergency department with a primary diagnosis of headache were analyzed. Headache disorders accounted for 1.7% of all visits to the emergency department. Migraine headache was the most common headache diagnosis representing 60% of headache visits followed by headache of no obvious source at 25%. Narcotics were the most common treatment employed (180 patient-visits) in all patients and non-steroidal anti-inflammatory agents were the second most common agent used (86 patient visits). Narcotics were also the most common therapy in migraine headache patients (152 patient-visits) while ergotamines were used in less than one-third of patient-visits (36 patient-visits). Therapy of headache patients in the emergency department continues to rely on narcotics. Methods of interrupting the dependence on narcotics need to be explored if newer non-narcotic therapies are to be successful.
头痛患者对于急诊科的医护人员来说是常见的诊断和治疗难题。治疗选择不断增加，但许多研究表明，麻醉药品仍然是常用的治疗手段。在这项回顾性横断面调查中，分析了以头痛为主诉到一所学术医疗中心急诊科就诊患者的评估和治疗模式。头痛疾病占急诊科所有就诊病例的1.7%。偏头痛是最常见的头痛诊断类型，占头痛就诊病例的60%，其次是不明原因头痛，占25%。麻醉药品是所有患者中最常用的治疗药物（180人次），非甾体抗炎药是第二常用药物（86人次）。麻醉药品也是偏头痛患者中最常用的治疗药物（152人次），而使用麦角胺的患者不到三分之一（36人次）。急诊科头痛患者的治疗仍然依赖麻醉药品。如果新型非麻醉治疗方法要取得成功，就需要探索中断对麻醉药品依赖的方法。
