癫患儿生活质量研究

Study on the quality of life in children with epilepsy

目的研究癫患儿生活质量的特点及其影响因素。方法对神经科门诊的93例癫患儿进行生活质量评定,并与在年龄、性别、文化程度等方面严格匹配的93名正常儿童进行对比。生活质量评定工具:抗癫药物的不良反应量表(SEP),青少年癫患儿的生活质量-48项量表(QOLIE-AD-48),焦虑自评量表(SAS),汉密尔顿抑郁量表(HAMD)。结果患儿常见的药物不良反应有皮疹、注意力不易集中、记忆障碍;患儿生活质量损害的范围广泛(P<0.01),其中社会支持的损害最明显;患儿焦虑抑郁的得分和对照组比较,差异有统计学意义(P<0.01)。多因素分析发现抗癫药物的不良反应、焦虑、抑郁、羞耻感与生活质量有相关性,且具有统计学意义(P<0.05)。结论除合理的药物治疗外,应对患儿进行包括心理干预的综合治疗以提高患儿的社会功能,全面提高患儿的生活质量。

Objectives To assess the characteristics and influencing factors of quality of life （QOL） in children with epilepsy in China. Methods QOL of 93 children with epilepsy followed up in the outpatient department of Children＇s Hospital of Fudan University were evaluated, and 93 healthy children （matched strictly in sex, age, education） were studied as control. Side effect profile （SEP）, quality of life in people with epilepsy adolescent-48 （QOLIE-AD-48）, selfrating anxiety scale （SAS）, Hamilton depression scale （HAMD） were included in QOL assessment. Results Common side effects in children with epilepsy were skin rash, concentration deficit and memory dysfunction. The QOL impairment in children with epilepsy were extensive （P 〈 0.01 ）. Deprived social support was the most obvious. The scores of SAS and HAMD in epilepsy group were significantly higher than those of control group （P 〈 0.01 ）. Multitude factors analyses showed side effects of antiepileptic drugs were anxiety, depression and stigma correlated with QOL （P 〈 0.05）. Conclusions Besides reasonable use of medications, comprehensive management including psychological intervention should be applied to children with epilepsy to improve their social function and QOL.