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目的研究上海市儿童及青少年慢性头痛的流行情况及特点,调查慢性头痛的影响状况及就诊情况。方法将上海市中小学生(6～15岁)进行分层整群随机抽样,采用问卷调查及专科随访的方式,调查慢性头痛的患病情况、头痛特点、影响因素及就诊情况。结果 (1)患病情况:共调查9857名学生,回收问卷8701份,回收率为88.6%,1481/8701(17%)有过头痛的经历,86.4%头痛原因不明;慢性头痛的患病率为7.8%,性别差异无统计学意义(x~2=0.010,P>0.05)。(2)慢性头痛的患病率随年龄的增加而增高,12岁前男性高于女性,12岁后女性超过男性。(3)儿童慢性头痛特点:头痛部位单侧、双侧或不详比例相似,颞部居多(35.2%),额部次之(25.6%);头痛持续时间短,消化道伴随症状突出;头痛程度,48.5%的患儿认为头痛影响学习、生活;头痛伴随症状以消化道症状最常见。(4)就医情况:24.0%的患儿就诊,其中30.9%的患儿头痛后寻求药物治疗。(5)相关影响因素:慢性头痛的常见诱因为过度疲劳(51.4%),睡眠不足(40.4%),情绪改变(38.5%),学习压力(24.1%);慢性头痛与阳性家族史、学习压力过大有关。结论慢性头痛是儿童常见的临床问题,近半数慢性头痛儿童的学习与日常生活受到影响,但多数患儿未得到医疗指导,此调查结果应引起医学、教育及社会的共同关注。
Objective To study the prevalence and characteristics of chronic headache in children and adolescents in Shanghai and to investigate the impact of chronic headache and the treatment of chronic headache. Methods The primary and secondary school students (6-15 years old) in Shanghai were randomly divided into stratified clusters. The questionnaires and specialist follow-up were used to investigate the prevalence of chronic headache, the characteristics of headache, the influencing factors and the treatment. Results (1) The prevalence of illness: A total of 9857 students were surveyed, 8,701 questionnaires were collected, the recovery rate was 88.6%, 1481/8701 (17%) had headache experience, and 86.4% had unknown headache. The prevalence of chronic headache Was 7.8%, no significant gender differences (x ~ 2 = 0.010, P> 0.05). (2) The prevalence of chronic headache increased with increasing age, before the age of 12 male than female, after 12 years of age more women than men. (3) chronic headache in children characteristics: headache unilateral, bilateral or unknown proportions similar to the temporal majority (35.2%), forehead (25.6%); short duration of headache, accompanied by prominent symptoms of the digestive tract; headache degree , 48.5% of children think that headache affects learning and living; headache accompanied symptoms are the most common gastrointestinal symptoms. (4) medical conditions: 24.0% of the children visited the hospital, of which 30.9% of children seeking medical treatment after a headache. (5) Related factors: Common causes of chronic headache were fatigue (51.4%), lack of sleep (40.4%), mood change (38.5%), study stress (24.1%), chronic headache and positive family history, Too much related. Conclusions Chronic headache is a common clinical problem in children. Nearly half of children with chronic headache suffer from learning and daily life. However, most children have no medical instruction. The findings of this survey should attract medical, educational and social concerns.