目的：本研究的目的是总结有关使用屏幕作为小儿头痛和偏头痛的一个影响因素的证据。
背景：屏幕暴露通常被报道为头痛的触发因素，尽管目前在屏幕类型方面还没有达成共识，持续时间,或频率影响小儿头痛和相关的疾病负担。
方法：在PubMed中进行系统搜索，Scopus,科克伦图书馆,ProQuest健康与医疗数据库,GoogleScholar根据系统审查和荟萃分析（PRISMA）声明的首选报告项目执行至2022年11月。包括所有年龄≤18岁的儿科患者的英语文章，这些文章评估了与头痛有关的屏幕使用情况。
结果：共纳入48项研究。几乎所有研究都是横断面的，代表了国际样本。发现屏幕使用和头痛之间最强的关联是使用持续时间，电脑使用成为与头痛相关的最常见的设备类型。虽然与屏幕使用和特定的头痛诊断有关的发现好坏参半，偏头痛似乎带来了更高的风险。在整个研究中，没有足够的数据来评估屏幕使用对头痛频率或头痛相关残疾的影响.几项研究表明，与COVID-19大流行和计算机视觉综合征相关的屏幕使用和头痛模式的变化是常见的报道。
结论：虽然有初步证据支持使用屏幕和小儿头痛之间的可能关联，本综述有几个局限性,包括缺乏更好地证明因果关系的前瞻性和随机对照试验,以及在定义和测量头痛和筛查使用方面存在显著差异的方法学局限性.需要进行包括实时屏幕使用和设备监测在内的未来研究，以更好地了解屏幕使用行为对小儿头痛的影响，并帮助进一步定义围绕这些技术的最佳使用指南。
OBJECTIVE: The aim of this study was to summarize the evidence regarding screen use as a contributing factor in pediatric headache and migraine.
BACKGROUND: Screen exposure is often reported as a headache trigger, though there is no current consensus in terms of how screen type, duration, or frequency influences pediatric headache and the associated burden of disease.
METHODS: A systematic search in PubMed, Scopus, Cochrane Library, ProQuest Health and Medical Database, and Google Scholar was performed through November 2022 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. All English-language articles of pediatric patients aged ≤18 years evaluating screen use in relation to headache were included.
RESULTS: A total of 48 studies were included. Nearly all studies were cross-sectional and represented international samples. The strongest association between screen use and headache found was for duration of use, and computer use emerged as the most common device type related to headache. While there were mixed findings related to screen use and specific headache diagnosis, migraine appeared to confer a higher risk. Across studies, there were insufficient data to assess the impact of screen use on headache frequency or headache-related disability. Several studies demonstrated changes in screen use and headache patterns related to the COVID-19 pandemic and computer vision syndrome was commonly reported.
CONCLUSIONS: While there is preliminary evidence supporting possible associations between screen use and pediatric headache, there are several limitations in the present
review including a lack of prospective and randomized controlled trials to better demonstrate causal relationships as well as methodological limitations with significant variability in how both headache and screen use are defined and measured. Future studies including real-time screen use and device monitoring are needed to better understand the influence of screen use behaviors on pediatric headache and to help further define best-use guidelines around these technologies.
