認識疼痛.ppt

* * * * * * * * * * * * 看了以上的報告 關掉冷氣，不但節能，又有益健康 你還是要開冷氣嗎？ * 高跟鞋的疼痛問題 腰酸背痛 退化性膝關節炎(OA) (Havard Study,1998) 外翻拇趾 * 60多歲,主訴HA…小時月內風… * 吃腦補腦?? * 腦重?.重量大是否較聰明? * 病人需學會描訴投頭痛特性..悶悶---甸甸—燒燒– 時間長短..特性..合併症狀—緩解情形—藥物..(醫師不會算命) * * Variant—一般有家族史. 無預兆偏頭痛 至少有5次能符合基準B-D的發作 B. 頭痛發作持續4-72小時 (未經治療或治療無效) C. 頭痛至少具下列二項特徵： 1. 單側 2. 搏動性 3. 疼痛程度中或重度 4. 日常活動會使頭痛加劇或避免此類活動（如走路或爬樓梯） D. 當頭痛發作時至少有下列一項： 1. 噁心及/或嘔吐 2. 畏光及怕吵 E. 非歸因於其他疾患 * Migraine is more than just head pain. Migraine is a process that can start long before head pain begins. The process of headache is generally believed to come in phases: preheadache (prodrome and aura), headache, and postheadache. The migraine process can begin at any phase, and not all phases present themselves (either in every migraine or at all). The process of migraine can also stop at any phase: in some cases sufferers have an aura; however, the headache never develops. The variability inherent in the migraine process and symptoms makes multiple migraine treatment options extremely important. Reference: Cady RK. Early intervention in the treatment of migraine. Headache Q. 2001;12(suppl 1):3-8. * 緩解-?status migrainous * Respondents were asked to self-report the severity of their headaches on this 4-item scale. Eighty percent of these symptom-defined sufferers reported severe or extremely severe headaches. * In this question respondents were asked, “How are you usually affected by your severe headaches?” There were 4 response choices : Able to work/function normally Working ability or activity impaired to some degree Working ability or activity severely impaired Bed rest required The severe impairment and bed rest codes were combined for this analysis. In 1999, over half of migraine sufferers reported that they were severely disabled or required bed rest and 92% had some disability. The distribution of impairment scores look similar, but there was a statistically significant (p.05) shift toward higher levels of impairment between 198