摘要
目的分析影响湖北省农村癫痫防治项目管理效果的主要因素,为进一步提高管理效果提供参考依据。方法按照农村癫痫项目苯巴比妥治疗管理方案对目标人群进行筛查、复核,符合入组标准的患者进入项目管理,进行定期随访、免费药物治疗、健康宣教等措施并填写调查资料,数据经过逐级审核后应用SPSS 20.0软件进行统计学分析。结果2015年1月1日至2020年12月31日期间,6个项目县服用苯巴比妥治疗管理的患者中,1430例治疗管理满1年以上,其中1119例(78.25%)观察期内无发作或发作次数减少75%以上;与其他年龄组相比,65岁及以上年龄段显效/有效比例最高(95.77%);从随访年限来看,5年及以上的显效/有效比例最高(91.51%);与入组前未接受治疗和接受正规治疗相比,接受不正规治疗的显效/有效比例最低(82.43%);1213例(84.83%)观察期间依从性良好,其中1062例(87.55%)发作次数较治疗前减少50%以上。单因素分析显示,患者年龄、随访年限、入组前治疗情况、苯巴比妥日平均剂量及患者的依从性均对管理效果有影响,差异有统计学意义(P<0.05)。多因素分析显示,在65岁及以上年龄组,患者的显效/有效率是低年龄组的6.749倍;入组前接受过非正规治疗是癫痫难控制的危险因素,接受不正规治疗的癫痫患者显效/有效率是从未治疗的0.29倍。依从性好是癫痫控制效果的保护因素,依从性好的患者显效/有效率是依从性不好患者的2.058倍。结论农村癫痫防治管理项目患者发作控制效果显著,早期治疗、规范治疗、提高治疗依从性是提高癫痫患者管理效果的有效途径。
Objective To analyze the main factors influencing the management effect of rural epilepsy prevention and control projects in Hubei Province,and to provide reference for further improving the management effect.Methods According to the phenobarbital treatment and management plan of the rural epilepsy project,the target population was screened and reviewed,and patients who met the inclusion criteria were enrolled into the project management.Regular follow-up visits,free drug treatment,health education and other measures were carried out,and all relevant information was collected and integrated into the survey data.After the data was reviewed level by level,SPSS 20.0 software was used for statistical analysis.Results From January 1,2015 to December 31,2020,among patients treated and managed with phenobarbital in 6 project counties,1430 patients were treated and managed for more than 1 year,of whom 1119(78.25%)had no seizures or had more than 75%reduction in the number of seizures during the observation period.Compared with other age groups,the age group of 65 years and above had the highest markedly effective/effective ratio(95.77%).From the point of follow-up,the markedly effective/effective ratio of 5 years and above was the highest(91.51%).Compared with those who received no treatment prior to enrollment and those who received regular treatment,the patients receiving informal treatment had the lowest markedly effective/effective ratio(82.43%).1213 cases(84.83%)had good compliance during the observation period,of whom 1062 cases(87.55%)had a reduction in the number of seizures by more than 50%compared with that before treatment.Univariate analysis showed that the age of patients,the length of follow-up,the treatment status before enrollment,the average daily dose of phenobarbital and the compliance of patients all had an impact on the management effect,and the difference was statistically significant(P<0.05).Multivariate analysis showed that the markedly effective/effective rate of patients in the age group of 65 years and above was 6.749 times that of the younger age group.Receiving informal treatment prior to enrollment was a risk factor for difficult-to-control epilepsy.The markedly effective/effective rate of patients receiving informal treatment was 0.29 times that of patients never receiving treatment.Good compliance was a protective factor for epilepsy control,and the markedly effective/effective rate of patients with good compliance was 2.058 times that of patients with poor compliance.Conclusion The epilepsy prevention and management project in rural areas has a significant effect on seizure control.Early treatment,standardized treatment,and improvement of treatment compliance are effective ways to improve the management effect of epilepsy patients.
作者
张佩君
韩胜红
李俊琳
齐俊锋
祝淑珍
ZHANG Peijun;HAN Shenghong;LI Junlin;QI Junfeng;ZHU Shuzhen(Hubei Center for Disease Control and Prevention,Wuhan,Hubei 430079,China)
出处
《公共卫生与预防医学》
2024年第3期54-58,共5页
Journal of Public Health and Preventive Medicine
关键词
癫痫
苯巴比妥
治疗效果
Epilepsy
Phenobarbital
Treatment effect
作者简介
第一作者:张佩君,主管医师,主要从事慢性病预防与控制工作;通信作者:祝淑珍,硕士研究生,主任医师,Email:42821232@qq.com。
