Jonata Ribeiro de Sousa, Maria Clara Arcoverde de Santana, Pedro Augusto Sampaio Rocha-Filho
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引用次数: 0
摘要
透析头痛（DH）在接受血液透析的患者中患病率从27%到73%不等。对其治疗方法的研究仍然有限。方法：本系统综述探讨DH的治疗方法。该研究是根据PRISMA声明进行的，并在PROSPERO注册（CRD42023493031）。使用的数据库如下：PubMed/Medline、LILACS/Scielo、Cochrane、Scopus、Web of Science、Embase和谷歌Scholar。结果：共纳入8项试验。一项对照临床试验表明，在血液透析期间观看喜剧电影与较少的头痛有关。另一项研究显示，喝咖啡没有任何好处。开放标签试验比较了不同的透析技术。与标准血液透析相比，配置型血液透析（钠和超滤联合）患者头痛较少，超滤率和血液滤过率自动调节的血液透析患者比标准血液透析患者头痛较少。阶梯式钠谱分析和线性钠谱分析没有区别。一项公开的临床试验报告了使用去甲替林后DH的强度和频率的降低。一项回顾性队列研究报告，与接受传统血液透析的患者相比，接受在线血液滤过（结合扩散和对流机制）的患者DH更少。结论：环境变化和透析技术的改变可能有助于降低DH的发生率。去甲替林可能改善DH。
Acute and prophylactic treatment of dialysis headache: a systematic review.
Introduction: Dialysis headache (DH) has a prevalence ranging from 27% to 73% among patients undergoing hemodialysis. Research on its treatment remains limited.
Methods: This systematic review explores the treatment of DH. It was conducted according to the PRISMA statement and registered in PROSPERO (CRD42023493031). The following databases were used: PubMed/Medline, LILACS/Scielo, Cochrane, Scopus, Web of Science, Embase and Google Scholar.
Results: Eight trials were included. One controlled clinical trial showed that watching comedy films during hemodialysis was associated with less headache. Another showed no benefit from drinking coffee. Open-label trials compared different dialysis techniques. There was less headache in profiled hemodialysis (combining sodium and ultrafiltration) than in standard hemodialysis, in hemodialysis using an automatic adjustment in ultrafiltration rate and hemofiltration than in standard hemodialysis. There was no difference between the step and linear sodium profiling programs. An open clinical trial reported a reduction in the intensity and frequency of DH after the use of nortriptyline. A retrospective cohort study reported less DH in patients undergoing online hemodiafiltration (combining diffusion and convection mechanisms) compared to those receiving conventional hemodialysis.
Conclusion: Environmental changes and changes in dialysis techniques may contribute to a lower incidence of DH. Nortriptyline possibly improves DH.
期刊介绍：
Expert Review of Neurotherapeutics (ISSN 1473-7175) provides expert reviews on the use of drugs and medicines in clinical neurology and neuropsychiatry. Coverage includes disease management, new medicines and drugs in neurology, therapeutic indications, diagnostics, medical treatment guidelines and neurological diseases such as stroke, epilepsy, Alzheimer''s and Parkinson''s.
Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections:
Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results
Article Highlights – an executive summary of the author’s most critical points
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