生酮饮食联合延续性护理对儿童难治性癫痫的治疗及护理研究

Study on the treatment and nursing of ketogenic diet combined with continuous nursing on children with refractory epilepsy

目的探讨生酮饮食(ketogenic diet,KD)联合延续性护理对儿童难治性癫痫治疗效果,为临床治疗和护理提供参考。方法选取2014年3月-2018年5月在我院进行治疗的难治性癫痫患儿42例,根据是否参与KD治疗分为观察组20例和对照组22例,观察组患儿采用KD联合延续性护理,对照组患儿采用常规的药物治疗,观察2组患儿治疗有效率、不良情绪、生活质量以及血脂水平。结果治疗后,观察组患儿有效率高于对照组(P<0.05);治疗后,观察组患儿总智商(FIQ)、言语智商(VIQ)、操作智商(PIQ)评分均高于对照组(P<0.05);观察组患儿情感健康、认知能力、行为功能评分均高于对照组(P<0.05),而躯体功能、社会功能差异无统计学意义(P>0.05),观察组患儿焦虑(SAS)、抑郁(SDS)评分低于对照组患儿(P<0.05),治疗后,观察组患儿总胆固醇(TC)、低密度脂蛋白(LDL-C)高于对照组(P<0.05),而甘油三酯(TG)、高密度脂蛋白(HDL-C)差异无统计学意义(P>0.05)。结论KD联合延续性护理可改善患儿疗效,改善患儿焦虑、抑郁评分,提高患儿生活质量,升高智力水平。

Objective To investigate the effect of ketogenic diet(KD)combined with continuous nursing on children with refractory epilepsy,and to provide information for clinical treatment.Methods 42 children with refractory epilepsy who were treated in our hospital from March 2014 to May 2018 were enrolled.The patients were divided into observation group(n=20)and control group(n=22)according to whether they participated in KD treatment.Children in the observation group were treated with KD combined with continuous care.The children in the control group were treated with conventional drugs.The effective rate,adverse mood,quality of life and blood lipid levels were observed in the two groups.Results After treatment,the effective rate of the observation group was higher than that of the control group,(P<0.05).After treatment,the total IQ(FIQ),speech IQ(VIQ)and operational IQ(PIQ)scores of the observation group were higher than those of the control group.(P<0.05).The scores of emotional health,cognitive ability and behavioral function of the observation group were higher than those of the control group,(P<0.05),but there was no significant difference in physical function and social function,(P>0.05).The scores of SAS and depression(SDS)were lower than those of the control group,(P<0.05)After treatment,the total cholesterol(TC)and low density lipoprotein(LDL-C)in the observation group were higher than those in the control group,(P<0.05).There was no significant difference in triglyceride(TG)and high density lipoprotein(HDL-C)(P<0.05).Conclusion KD combined with continuous nursing can improve the curative effect of children,improve the anxiety and depression scores of children,improve the quality of life of children,and increase the intelligence level.