2019 年第 6 期 第 14 卷

全程个性化干预对难治性癫jian患儿生酮饮食治疗依从性的改善效果

Effect of full-course personalized intervention on compliance of ketogenic diet in children with refractory epilepsy

作者：乔红丽刘晓鸣李玮玮

英文作者：

单位：221000江苏省徐州市儿童医院神经内科

英文单位：

关键词：难治性癫jian；生酮饮食；全程个性化干预；治疗依从性

英文关键词：

• 摘要：

• 【摘要】目的    探讨全程个性化干预与常规干预对难治性癫jian患儿生酮饮食治疗依从性的改善效果。方法    选择江苏省徐州市儿童医院2016年4月至2018年4月收治的难治性癫jian患儿104例，应用随机数字表法分为观察组和对照组，各52例。对照组患儿接受常规干预措施，根据常规护理程序对患儿进行入院指导，遵医嘱给予药物治疗，并实施饮食指导，指导患儿家长生酮饮食的配置方法。观察组实施全程个性化干预，组建生酮饮食治疗干预小组，于治疗前、住院期间、出院后全程实施个性化干预，组织疾病知识讲座和活动。比较干预6个月后2组患儿生酮饮食治疗依从性、疾病控制效果和患儿家长对疾病相关知识的知晓率。结果    干预6个月后，观察组患儿生酮饮食治疗依从性、疾病控制有效率均高于对照组［96.2%(50/52)比75.0%（39/52）、84.6%（44/52）比63.5%（33/52）］，患儿家长对疾病相关知识的知晓率高于对照组［98.1%(51/52)比75.0%（39/52）］，差异均有统计学意义（均P<0.05）。结论    全程个性化干预应用于难治性癫jian患儿中可显著提高其生酮饮食治疗依从性，增强患儿家长对疾病相关知识知晓度，有效控制患儿的癫jian发作。

• 【Abstract】Objective    To investigate the effect of personalized intervention on the compliance of ketogenic diet in children with refractory epilepsy. Methods    Totally 104 children with refractory epilepsy admitted to Xuzhou Children′s Hospital from April 2016 to April 2018 were randomly divided into observation group and control group, with 52 cases in each group. The control group had routine treatments, including conventional nursing, medication and dietary guidance; parents were taught the constituents of ketogenic diet and how to do diet regulation. The observation group had full-course personalized intervention; ketogenic diet was guided by professional team during hospitalization and after discharge; lectures and activities about epileptic management were organized among children and parents. Compliance of ketogenic diet in children, disease control effect and medical knowledge of parents were analyzed. Results    After 6 months of intervention, the compliance of ketogenic diet and the disease control rate in observation group were significantly higher than those in control group［96.2%(50/52) vs 75.0%(39/52), 84.6%(44/52) vs 63.5%(33/52)］； parents′ awareness of epilepsy in observation group was significantly higher than that in control group［98.1%(51/52) vs 75.0%(39/52)］(all P<0.05). Conclusion    Full-course individualized intervention in children with refractory epilepsy can significantly improve the compliance of ketogenic diet, enhance the disease knowledge of family members and effectively control epileptic seizures.