内蒙古赤峰地区蒙古族癫癎患者诊疗现状

The diagnosis and treatment of the Mongolian People with epilepsy in Chifeng, Inner Mongolia

目的：通过对1295例蒙汉两组活动性癫癎患者的诊断和治疗情况进行调查、分析比较，找出蒙古族癫癎患者在诊断治疗等各方面存在的不足和缺口，从而为积极探索行之有效的针对少数偏远地区癫癎患者的规范诊疗和管理模式提供依据。方法：由经过专业培训的神经内科医生和护士（含蒙古族医生和护士）对已确诊的入选蒙、汉两组癫癎患者和家属进行问卷调查。调查内容包括患者一般情况、疾病情况、就诊情况、癫癎知晓情况、服药依从性等方面，并进行统计学分析。结果：蒙汉两组癫癎患者相比，在影响规范诊疗因素差异有显著意义（P：0．01）。蒙古族癫痴患者及家属对癫癎知识知晓率为40．84％，汉族为51．08％，蒙古族患者及家属知晓率明显低于汉族患者；蒙古族患者较汉族癫癎患者治疗依从性差。结论：内蒙古赤峰地区蒙古族癫癎患者的诊治状况令人堪忧，对癫癎病的认识和重视程度低、就医取向不正确、癫癎患者及家属对疾病知晓率低、交通不便和民族信仰的影响，特别是基层医疗机构专业技术水平不足是导致现状的主要原因。强化基层医生专业化培训；普及癫痴科普知识，提高治疗依从性；增加对基层医疗的投入，特别是增加癫癎病人报销比例如特殊门诊等是改善蒙古族地区癫癎诊疗现状的主要措施。

Objective： A total of 1295 Chinese Mongolian and Han patients with active epilepsy were enrolled into two groups for investigation, analysis and comparison of diagnosis and treatment to find out shortcomings and deficiencies concerning diagnosis and treatment for Inner Mongolian patients with epilepsy so as to provide evidence for effective diagnosis, treatment and management patterns for patients with epilepsy in remote districts of minority people. Methods： A questionnaire survey was conducted in enrolled Inner Mongolian and Han patients with epilepsy and in their relatives by professionally trained neurological physician and nurses （including Inner Mongolian physicians and nurses）. The survey covered general conditions of patients, alsease conditions, physician--visit conditions, levels of under- standing of epilepsy, medication compliances and others, based on which statistical analysis was conducted. Results：There was significant difference in factors influencing standard diagnosis and treatment and in treatment deficiency between Inner Mongolian and Han patients with epilepsy （P〈0.01）. The rate of knowing epilepsy-concerned knowledge was 40.84% in Inner Mongolian patients with epilepsy and their relatives, being obviously lower than the rate in the Han group （51.08 %） ; the treatment compliance was poorer in Inner Mongolian patients than in Han patients with epilepsy. Conclusion： Current conditions concerning diagnosis and treatment of inner Mongolian epilepsy patients in Chifeng of Inner Mongolia are worrying. Factors, including relatively low level of cognition of epilepsy, less attention to the disease, incorrect orientations of seeking medical advice, less knowledge about epilepsy from both epilepsy patients and their relatives, inconvenient transportation, impacts of economic condition and ethnic belief, and especially, under--level professional skills in community medical institutions, are major causes of anxious current situation. Enhancing professional trainings of community physicians, popularizing knowledge concerning epilepsy and improving treatment compliance, and increasing community medical investment, especially increasing the proportion of reimbursement for epilepsy patients （such as special outpatient departments）, are principal measures to improve current conditions concerning diagnosis and treatment of epilepsy in areas inhabited by Mongolians.