依从性对儿童癫痫治疗疗效的影响及对策

发布时间：2018-03-18 14:23

本文选题：儿童癫痫　切入点：依从性　出处：《新乡医学院》2017年硕士论文　论文类型：学位论文

【摘要】：背景癫痫是一种常见的神经系统疾病,相关人员统计后发现,我国的癫痫患者将近900万人,患病率高达到7%,而新癫痫病例正在以约每年40万人次快速增加,其中绝大部分的癫痫患者在长期规律治疗过程中,得到缓解控制,但仍有约五分之一的患者最后发展成为难治性癫痫[1]。新医学模式逐渐完善,影响不同类型癫痫治疗的各种因素也逐渐引起人们的重视。全面提高患者的治疗疗效,并且减少综合药物和多方面的因素带来的副作用,最终达到提高患者的生活质量。就目前而言。临床中口服抗癫痫药物(anti-epileptic drags,AEDs)仍然是抗癫痫治疗的首选方案。癫痫本来就是个慢性病、长期病。癫痫药物治疗的疗效、发作后服药时间、服药过程中的注意事项以及停药后复发率可能成为患者及家属关心的核心问题。一部分患儿癫痫发作不能得到很好地控制,除疾病本身的因素外,依从性也是其不可忽视的因素之一。国内外研究调查就发现癫痫患者中无依从性的发生率约为25%~50%,私自换用癫痫药物、未遵医嘱下私自换用或者停用药等均可以归为不依从的范围,导致癫痫难以控制,最严重可能发生癫痫持续状态[2-3]的根源之一。癫痫患者中,儿童可能属于癫痫的高发人群。对于我国这样一个癫痫大国来说,儿童的发病率也明显超过成人。目的通过对影响癫痫患者依从性相关因素进行分析、归纳和总结,进一步探讨这些相关因素对儿童癫痫患者疗效的影响。同时在此基础上提出儿童癫痫患者依从性的相关对策,以改善儿童癫痫患者临床治疗效果,并提升其生活质量。方法2014年7月-2015年7月期间河南省人民医院儿科门诊收治的84例患儿,临床诊断为癫痫,对这些患儿的临床资料和治疗方法进行分析,并发放自行设计的调查问卷进行调查分析,将所有的调查问卷进行总结,分别从儿童癫痫患儿的就诊时间、家长诊治意识、坚持定期复诊、维持长期用药等方面归纳分析,并从这几个方面对儿童癫痫患者依从性的相关因素。同时通过跟踪随访,分析依从性对治疗疗效的影响。采用SPSS20.0统计软件对数据进行分析和处理,以P0.05为差异具有统计学意义。结果1.本次问卷调查发现:患儿监护人的年龄、教育程度、生活背景等与癫痫患儿就诊意识、就诊时间、规律服药、定期复查等因素具有相关性。2.经过对比研究发现就诊意识,就诊时间、规律服药、定期复查等与依从性具有明显的相关性,P0.05,差异具有统计学意义。3.本次实验研究显示,依从性的好坏对患儿疾病预后具有明显的相关性,通过卡方检验X2=26.56,P0.05,差异具有统计学意义。结论患儿监护人教育程度、生活背景等各个方面的因素直接影响到癫痫患儿就医时间、遵医嘱的程度。治疗期间不能按时服药、患儿家长文化程度低、对疾病的认识少、由于客观原因患儿无规律的复诊及服药均不利于疾病恢复。这些因素在一定程度上影响依从性。癫痫患儿治疗的依从性越差,其治疗的效果就越差。对于患儿监护人,治疗效果差会让他们对治疗失去信心或者病急乱投医,最后导致疾病得不到良好的控制。针对上述情况,临床医生在癫痫患儿治疗期间,要及时对其家长进行有针对性的健康教育,并充分沟通,得到家长重视,并能够争取到他们的积极配合,提高依从性及疗效。
[Abstract]:Background epilepsy is a common neurological disease, related personnel statistics showed that China's epilepsy patients nearly 9 million people, the prevalence rate reached 7%, and the new cases of epilepsy is about 400 thousand times a year increased rapidly, and the vast majority of patients with epilepsy in long-term regular treatment process, ease control, but still there are about 1/5 of the patients become refractory epilepsy [1]. new medical mode is gradually perfect, various factors of different types of epilepsy treatment has gradually aroused people's attention. Improve the curative effect in the treatment of patients, and reduce the factors in many aspects and drug side effects, and finally improve the quality of life of patients. For now. The clinical oral antiepileptic drugs (anti-epileptic, drags, AEDs) is still the preferred scheme of anti epilepsy treatment. Epilepsy is a chronic disease, chronic disease of epilepsy. Effect of antiepileptic medication, medication time after the onset, the matters needing attention in the process of treatment and relapse rate after may become the core problem of patients and their families concerned. Part of the children's seizure can not get good control, in addition to the factors of the disease itself, compliance is also one of the factors which can not be ignored. The domestic and foreign research investigation found no compliance of epilepsy patients the incidence is about 25%~50%, with epilepsy drugs for privately, noncompliance with or without change under the discontinuation of drugs can be classified as the scope of non-compliance, resulting in epilepsy is difficult to control, the worst possible source of status epilepticus [2-3] in patients with epilepsy. In the high risk population of children may belong to epilepsy. For such a seizure in our country, the incidence of children is significantly more than adults. Objective to influence compliance and related factors in patients with epilepsy. For the analysis, the induction and the summary, further explore the impact of these factors on the curative effect of children with epilepsy. At the same time puts forward relevant measures for children with epilepsy patient compliance, to improve clinical curative effect for children with epilepsy, and improve their quality of life. Methods in July 2014 -2015 year in July 84 cases admitted to the outpatient department of Pediatrics, Henan Province People's Hospital, clinical a diagnosis of epilepsy, the clinical data and treatment methods for these children were analyzed, and the questionnaire designed by the investigation and analysis of the questionnaire, all of the total, respectively from children with epilepsy treatment time, diagnosis and treatment of parents awareness, adhere to regular follow up and maintain long-term medication and other aspects of analysis of related factors children with epilepsy compliance from these aspects. At the same time and followed up by the analysis on the compliance of therapy. Ring. The data were analyzed by SPSS20.0 statistical software, using P0.05 as the difference was statistically significant. The results of the 1. survey found that: with the guardians of the age, level of education, taking the life background and treatment of children with epilepsy awareness, treatment time, law, periodic review and other factors associated with.2. were found after the comparative study awareness, treatment time, regular medication, regular follow-up and compliance has obvious relevance, P0.05, the difference has statistical significance in this experiment.3. showed that compliance is significantly correlated with the prognosis of the disease, through the chi square test X2=26.56, P0.05, the difference was statistically significant. Conclusion the children's Guardian education, the background of life and other aspects of the factors that directly affect the children with epilepsy treatment time, doctor degree. During treatment can not take medication, children home Long low cultural level, the understanding of the disease, due to objective reasons and referral medication in children with no rules are not conducive to the recovery of the disease. These factors affect compliance in some extent. The treatment compliance of children with epilepsy is poor, the treatment effect is worse. For the children's guardian, poor treatment effect will make them to lose confidence in treatment or critically ill patients, resulting in disease is not well controlled. In view of the above situation, clinicians in children with epilepsy during the treatment, the parents should be timely targeted health education, and fully communicate, parents can get attention, and actively cooperate with them, improve compliance and the curative effect.

【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.1

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