甘肃农村地区苯巴比妥治疗癫痫患者退组原因分析

Analysis of withdrawal reason for epileptic patients treated with phenobarbital in rural areas of Gansu

目的分析甘肃省农村地区服用苯巴比妥治疗惊厥性癫痫患者的退组原因,探讨癫痫患者服药的依从性,提高患者的疗效和生活质量。方法对2010年1月─2013年12月退组的377例惊厥性癫痫患者追踪回访,填写调查表,对退组者的性别、年龄、退组时间及原因等情况进行统计学分析。结果使用苯巴比妥治疗管理的4 026例患者中有377例退出治疗、退组率为9.36%,女性退组率高于男性,差异有统计学意义（χ2=4.663,P〈0.05）;退组年龄集中在10岁~组、占退组总数的26.53%,各年龄组差异无统计学意义（χ2=3.453,P〉0.05）;退组时间多发生于治疗前三个月内,与其他时间退组者差异有统计学意义（χ2=31.082,P〈0.05）,第四个月后退组患者明显减少;退组原因主要有依从性差、外出打工和疗效差等,因依从性差而退组明显高于其他原因的退组（χ2=10.704,P〈0.05）。结论甘肃省农村地区癫痫患者退组率女性高于男性,治疗前三个月内易退组,主要原因是患者依从性差;在今后的工作中,应加强对癫痫防治知识的宣传教育,特别是在入组治疗前及服药初期对患者及家属反复强调依从性的重要性,以提高患者的治疗效果。

Objective To learn withdrawal reason for epileptic patients treated with phenobarbital in rural areas of Gansu province, analyze the influencing factors of the withdrawal, and to explore strategies of enhancing compliance of the patients,improve their efficacy and quality of life. Methods Follow-up survey was conducted in 377 withdrawal epileptic patients treated from January, 2010 to December, 2013. Their sex, age, time of treatment and the causes of the withdrawal were statistically analyzed. Results Out of the 4 026 cases treated and administrated with phenobarbital, there were 377 cases exited the treatment, with the withdrawal rate of 9.36%. It was higher in the female than in the male, with statistical difference（χ2=4.663, P〈0.05）. The withdrawal mainly concentrated in the age group from 10 to 20 year-old, accounting for 26.53%. There was no statistical difference among the age groups（χ2=3.453, P〉0.05）. Withdrawal occurred mainly within treatment of 3months, and there was statistical difference compared with that happened in the other time（χ2=31.082, P〈0.05）. The withdrawal decreased obviously in the fourth month. The principal withdrawal reason was poor compliance, going out to work,poor therapeutic effect, and so on. There was statistical significance between poor compliance and other reasons（χ2=31.082,P〈0.05）. Conclusions The withdrawal rate of epileptic patients is higher in the female than in the male in rural areas of Gansu province. The patients easily withdraw from the treatment within the first 3 months, with the main reason of poor compliance. In the future work, it is important to strengthen epilepsy prevention knowledge and to stress the importance of compliance to the treatment and administration in patients and their families, so as to enhance treatment effect and the quality of life of patients.