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目的初步调查西藏农村地区惊厥性癫癎患病率、治疗缺口及患者生活质量。方法利用统一的调查表,对西藏拉萨市墨竹工卡县工卡镇和扎西岗乡、昌都地区芒康县曲孜卡乡进行整群逐户问卷调查。结果共调查14 822人,确诊惊厥性癫癎患者37例,患病率0.25%,其中活动性癫癎患者35例(94.59%),患病率为0.24%。调查前1周内接受西药正规治疗者1例,治疗缺口为97.1%。癫癎患者生活质量评定量表-31(QOLIE-31)总评分平均为(42.15±17.63)分,其中各分项得分中发作担忧得分最低[(22.59±20.31)分]、药物影响的评分最高[(85.83±18.59)分]。年龄、职业、文化程度、经济状况、起病年龄、发作次数为 QOLIE-31低评分的影响因素(P<0.05)。结论西藏农村地区惊厥性癫癎患病率为0.25%,西药治疗缺口大,主要以藏医藏药治疗为主,对西药治疗癫癎的了解很少,生活质量评分低。探索藏西医结合防治癫癎、提高当地医护人员的癫癎防治知识及公众的健康意识迫在眉睫。
Objective To investigate the prevalence rate of convulsive epilepsy, treatment gap and quality of life in rural areas of Tibet. Methods Using a unified questionnaire, we conducted a cluster-by-household questionnaire survey of Gongka Township, Zhaxigang Township, Mozhu Gongka County, Lhasa, Tibet and Quzize Township, Mankang County, Changdu Region. Results A total of 14 822 people were surveyed, of which 37 were diagnosed with seizure-induced epilepsy. The prevalence rate was 0.25%, of which 35 were active epilepsy (94.59%), the prevalence was 0.24%. One case received regular western medicine within one week before the survey, the treatment gap was 97.1%. The average score of QOLIE-31 in epileptic patients was (42.15 ± 17.63) points, among which the score of episode anxiety was the lowest [(22.59 ± 20.31) points], the highest score of drug influence [(85.83 ± 18.59) minutes]. Age, occupation, educational level, economic status, age of onset, number of seizures were the influencing factors of QOLIE-31 low score (P <0.05). Conclusions The prevalence of convulsive epilepsy in rural areas of Tibet is 0.25%. There is a large gap in the treatment of western medicine. The main treatment is Tibetan medicine. There is little understanding of epilepsy in western medicine and the quality of life score is low. Exploring Tibetan medicine combined with prevention and treatment of epilepsy, to improve local health care workers in the prevention and treatment of epilepsy knowledge and public awareness of health is imminent.