颈源性头痛的诊断与序贯治疗  

Diagnosis and sequential therapy of cervicogenic headache

作　　者：安海水[1] 姚军[1] 陈静[1] 李永乐[1] 郝明珠[1] 徐新辉 

机构地区：[1]河北大学附属医院麻醉科,河北保定071000 [2]河北省徐水县人民医院,河北保定072550

出　　处：《医学研究与教育》2010年第6期41-43,共3页Medical Research and Education

基　　金：河北省科学技术研究与发展指导计划课题(052761707)

摘　　要：目的对颈源性头痛患者进行诊断和治疗。方法根据颈源性头痛的临床表现和影像特点分为神经炎型、软组织型、椎间盘源型,分别采用神经阻滞、神经阻滞复合针刀松解、颈椎硬膜外注射皮质激素和胶原酶的方法进行序贯治疗,且与药物治疗进行比较,观察其治疗效果。结果在治疗后3~6个月内随访,神经炎型、软组织型、椎间盘源型颈源性头痛的治疗优良率分别为90.7%、84.0%、87.8%,均明显高于药物治疗组（P〈0.01）。结论采用神经阻滞、神经阻滞复合针刀松解、颈椎硬膜外注射皮质激素和胶原酶分别用于神经炎型、软组织型、椎间盘源型颈椎病疗效显著,可作为各型颈源性头痛的有效治疗方法。Objective To make a classified diagnosis and sequential therapy of cervicogenic headache.Methods According to clinical manifestion and imaging procedure,the cervicogenic headache patients were divided into three types—neuritis cervicogenic headache,softtis cervicogenic headache and cervical prolapsed vertebral disc cervicogenic headache.These neuritis cervicogenic patients were treated by nerve blocking,softtis cervicogenic headache were treated by nerve blocking and acupotomy,cervical prolapsed vertebral disc cervicogenic headache were treated by injection of triamcinolone acetonide and collagenase in cervical epidural.In the control group,these patients were treated by only drug treatment.The clinical effects were observed after being treated for 3 month to 6 month. Results The cure and improved rates after 3 months to 6 months were 90.7% in the neuritis cevicogenic headache group,84.0% in the softtis cervicogenic headache group,87.8%in the cervical prolapsed vertebral disc cervicogenic headache group.All the cure and good rates of cervicogenic headache groups were significantly greater than that in control groups（P0.01）.Conclusion The ways applied in these neuritis cervicogenic patients treated by nerve blocking,softtis cervicogenic headache patients treated by nerve blocking and acupotomy,cervcal prolapsed vertebral disc cervicogenic headache patients treated by injection of triamcinolone acetonide and collagenase in cervical epidural are effective treating methods.

关 键 词：颈源性头痛 诊断 影像特点 分型 药物治疗 序贯治疗 

分 类 号：R4[医药卫生—临床医学]