2010—2020年河南省南阳市农村地区惊厥性癫痫患者现状及治疗缺口分析  

Status and treatment gap analysis of convulsive epilepsy patients in rural areas of Nanyang City from 2010 to 2020

作　　者：刘伟 王成申 LIU Wei;WANG Chengshen(Nanyang Center for Disease Control and Prevention,Nanyang,Henan 473000,China)

机构地区：[1]南阳市疾病预防控制中心,河南南阳473000

出　　处：《现代疾病预防控制》2025年第2期139-143,共5页MODERN DISEASE CONTROL AND PREVENTION

摘　　要：目的 了解河南省南阳市农村地区惊厥性癫痫患者的治疗缺口及影响因素,为癫痫病规范化防治工作提供依据。方法 收集2010—2020年南阳市方城县、社旗县、淅川县3个项目县纳入的惊厥性癫痫患者的基本情况和治疗情况数据,采用SPSS 25.0软件对患者年龄、首次发作年龄、发作次数、治疗现状、治疗缺口及影响因素等进行分析。结果 2010—2020年共纳入惊厥性癫痫患者3 911例,南阳市农村地区惊厥性癫痫患者的治疗缺口为73.97%,不同性别间治疗缺口差异无统计学意义(χ^(2)=0.028,P>0.05),不同年龄组患者、不同首发年龄、不同发作次数、不同就诊医院级别的治疗缺口差异均有统计学意义(χ^(2)值分别为10.642、10.656、6.090、43.215,P均<0.05)。多因素logistic分析结果显示,>18~35岁年龄组[以患者年龄≤6岁为参照,>18~35岁组OR值(95%CI)为0.380(0.220~0.657)]、市/县级医院就诊患者[以个体医生/从未就诊为参照,就诊于市/县级医院OR值(95%CI)为0.424(0.313~0.575)]更倾向接受正规治疗;发作频率>10次/年[以发作频率≤5次为参照,发作频率>10次/年OR值(95%CI)为1.267(1.063~1.510)]、>20~40岁年龄组首次发病[以首次发作年龄≤3岁为参照,>20~40岁组OR值(95%CI)为1.446(1.087~1.924)]的治疗缺口较大。结论 南阳市农村地区惊厥性癫痫患者接受正规治疗缺口较大,相关部门应重视发挥基层医疗机构的特点和优势,加强基层医生培训来改善农村地区惊厥性癫痫的现状。Objective To understand the treatment gap of convulsive epilepsy patients and its influencing factors in rural areas of Nanyang City,Henan Province,so as to provide the evidence for future prevention and treatment.Methods The general information and treatment data for the patients with convulsion epilepsy enrolled in the project of Fangcheng County,Sheqi County and Xichuan County from 2010 to 2020 were collected;the data of the patients including age,age of initial onset,seizure frequency,the treatment status,treatment gap and related influencing factors were analyzed using SPSS 25.0.Results A total of 3 911 patients with convulsive epilepsy were enrolled in this study from 2010-2020,and the treatment gap of convulsive epilepsy in rural areas of Nanyang was 73.97%.There was no statistically significant difference in the treatment gap between different sex (χ^(2)=0.028,P>0.05);there were statistically significant differences in the treatment gap among different age groups,different age of initial onset,different seizure frequency,and different consultation hospitalization levels (χ^(2)=10.642,10.656,6.090,43.215,respectively,and all P<0.05).Multivariate logistic regression analysis showed that patients aged>18-35 years[Taking≤6 years old asreference,>18-35years old OR(95%CI):0.380 (0.220-0.657)]and consultation in municipal and countyhospitals[Takingindividual-doctor clinics/no consultation as reference,consultation in municipal and countyhospitals OR(95%CI):0.424 (0.313-0.575)]were more likely to receive regular anti-epileptic treatment;the seizure frequency more than 10[Taking≤5 times as reference,>10 times per year OR(95%CI):1.267(1.063-1.510)]and age of initial onset in the groups>20-40 years[Taking the age of initial onset of≤3 years as reference,>20-40 years OR(95%CI):1.446 (1.087-1.924)]had a large treatment gap.Conclusions There is a large gap of regular anti-epileptic treatment among epilepsy patients in rural areas of Nanyang City;the advantage of grass roots medical and health in stitutions shou

关 键 词：癫痫 农村地区 癫痫治疗 治疗缺口 

分 类 号：R742.1[医药卫生—神经病学与精神病学]