| Research background:Refractory epilepsy in children by means of two or more antiepileptic drugs, still cannot completely control the seizures, also known as drug-refractory epilepsy in children. Harm to children’s health seriously. The ketogenic diet (KD) is a high proportion of fat, low-carbohydrate ratio and protein enough to growth and development needs of the diet program. KD can be used to treat children with medical refractory epilepsy. KD therapy develops slowly in our country, at present only a few units to carry out this work and on the stage of exploring research. The efficacy of the ketogenic diet in general takes a long time to reflect, because of its slow onset, the treatment cycle length lead to the majority of children who drop out halfway. What factors influence the effect of the ketogenic diet and compliance deserves to be discussed, and long-term management of the ketogenic diet has important significance.ObjectiveiTo explore the efficacy of KD treatment to children,and compliance factors through analyzing the efficacy of the ketogenic diet treatment, seizure con trol rates and adhere to the case. At the same time, it is helpful for ketone diet ther apy home care by ways of solutions for the identified problems and long-term ma nagement so that we can improve the effectiveness of treatment and compliance, e liminate adverse reactions to ketogenic diet and improve the life quality of childre n with intractable epilepsy.Methods I Influencing factors were analyzed to find the solutions by means of a retrospective analysis of basic information as well as situations about children (total 57 cases) with intractable epilepsy who received ketogenic diet treatment in our hospital from Jan 2011 to Aug 2012 as control group. Children (52 cases) as observation group were researched after Sep 2012 through questionnaire of ketogenic diet compliance and telephone follow-up questionnaire. According to the findings, to make long-term management plan to patients depended on the ketogenic diet and implement. Besides, to assess the long-term management of the ketogenic diet by evaluation of effectiveness rates and compliance rates on the basis of statistical data about observation group and control group in different time periods and analyze compliance factors of the ketogenic diet.Result:Comparison of basic data between the two groups of children patients: the observation group were 52 cases,28 males and 24 females, average age 4.81 ± 3.10 years; the control group were 57 cases,32 mals and 25 females, average age 4.62±3.35 years old. Gender, age of onset, duration, age of the ketogenic diet, form of attack between the two groups are not statistically significant.Comparison of seizure control rate between observation group and the control group:there were statistically significant in the efficiency differences of the 1st, 3rd,6th,9th months in the two groups of children during the ketogenic diet.Comparison of ketogenic diet compliance rate (the ratio that continue to receive treatment in children patients accounts for the ratio of children patients enrolled)between observation group and the control group:no difference occurred between the observation group and the control group in the 1st month, there were statistical significance in the difference of 3rd,6th,9th months.Comparison of reasons for ketogenic diet termination between Observation group and the control group:Observation group stopped for various reasons accounted for 19 cases, and in the control group was 41 cases. Although the reasons for the termination of the rest scattered, but the proportion which terminated due to various reasons in the control group is higher than that in the observation group, and is statistically significant.The relationship between ketogenic diet adverse and the occurrence time shows that adverse reactions are more common in the first month of ketogenic diet, The incidence of adverse reactions showed a decreasing trend with the extension of the time of the ketogenic diet, and the difference of the adverse reaction between the first month and the ninth months of ketogenic diet were statistically significant.Conclusion:Intractable epilepsy in children mainly come from rural area. Conducting long-term management for children of Ketogenic diet can improve control rare and compliance of seizures, reduce the incidence of adverse reactions during the ketogenic diet therapy,improve life quality of child patients. The efficacy of the ketogenic diet, family economic situation, understanding way, confidence and expectations of the ketogenic diet are the main factors that affecting the compliance. |
PDF Full Text Request