作者：刘志敏，桑琳霞，李文玲，闫中杰

单位：

050000河北省石家庄市，河北医科大学第二医院神经外科

Units：

Department of Neurosurgery, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China

关键词：

难治性癫痫；延续性护理；复发；影响因素分析

Keywords：

Intractable epilepsy; Continuous nursing care; Recurrence; Root cause analysis

CLC：

R 742.1

DOI：

10.12114/j.issn.1008-5971.2023.00.306

Funds：

河北省自然科学基金精准医学联合基金培育项目（H2021206449）；河北省医学科学研究课题计划项目（20190049， 20230030）；河北省政府资助临床医学优秀人才培养项目（ZF2024046）；河北省医学适用技术跟踪项目（GZ2024028）

摘要：

目的　分析难治性癫痫患者外科治疗后延续性护理效果及其复发的影响因素。方法　选取2020年1月 至2022年4月在河北医科大学第二医院接受癫痫病灶切除术、电极植入术及迷走神经刺激术的166例难治性癫痫患者为 研究对象，采用随机数字表法将其分为对照组和试验组，每组83例。对照组患者出院前接受常规护理；试验组患者出 院前接受常规护理（同对照组），出院后接受延续性护理干预。比较两组出院后1年内复发情况及出院后1年癫痫患者 生活质量评定量表-31（QOLIE-31）评分。难治性癫痫患者出院后1年内复发的影响因素分析采用多因素 Logistic 回归 分析。结果　对照组出院后1年内复发率为44.6%（37/83），低于试验组的25.3%（21/83）（χ 2 =6.784，P =0.009 ）。 出院后1年，试验组发作担忧、生活满意度、情绪、精力/疲劳、认知功能、药物影响、社会功能维度评分及QOLIE-31 总分高于对照组（P＜0.05）。多因素Logistic回归分析结果显示，年龄、病程、癫痫发作类型及服药依从性是难治性 癫痫患者出院后1年内复发的独立影响因素（P＜0.05）。结论　延续性护理能降低难治性癫痫患者外科治疗后的复发 率，提高其生活质量；且年龄、病程、癫痫发作类型及服药依从性是难治性癫痫患者复发的独立影响因素。

Abstract：

Objective To analyze the effect of continuous nursing care and influencing factors of recurrence in patients with intractable epilepsy after surgical treatment. Methods A total of 166 patients with intractable epilepsy who underwent epilepsy lesion resection, electrode implantation, and vagus nerve stimulation surgery at the Second Hospital of Hebei Medical University from January 2020 to April 2022 were selected as the study subjects. They were randomly divided into control group and experimental group by random number table method, with 83 patients in each group. The control group received routine care before discharge; the experimental group received routine care before discharge (same as the control group) and continued nursing intervention after discharge. The recurrence within one year after discharge and Quality of Life in Epilepsy-31 (QOLIE-31) scores at one year after discharge were compared between the two groups. Multivariate Logistic regression analysis was used to analyzed the influencing factors of recurrence within one year after discharge in patients with intractable epilepsy. Results The recurrence rate within one year after discharge of the control group was 44.6% (37/83) , which was lower than 25.3% (21/83) of the experimental group ( χ 2 =6.784, P=0.009) . At one year after discharge, scores of symptomatic anxiety, life satisfaction, emotions, energy/fatigue, cognitive function, medication impact and social function items, and total score of QOLIE-31 in the experimental group were higher than those in the control group (P < 0.05) . Multivariate Logistic regression analysis results showed that age, course of disease, type of seizures and medication compliance were independent influencing factors of recurrence within one year after discharge in patients with intractable epilepsy (P < 0.05) . Conclusion Continuous nursing care can reduce the recurrence rate of patients with intractable epilepsy after surgical treatment and improve their quality of life. Age, course of disease, type of seizures, and medication compliance are independent influencing factors of recurrence in patients with intractable epilepsy.

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