Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Epilepsy Behav. 2010 Jan;17(1):75-81. doi: 10.1016/j.yebeh.2009.10.013. Epub 2009 Nov 11.
To establish an operational model of a network for managing patients with convulsive epilepsy in rural areas of West China.
The network is under unified leadership of the public health administration departments, who liaised with medical institutions and disease control and prevention organizations to foster local communities to participate. Patients with convulsive epilepsy were treated with phenobarbital. Trained local primary health care physicians carried out screening, treatment, and follow-up. Political, financial, and technological support was incrementally provided through the network. Efficacy was assessed as the percentage reduction in seizure frequency and the retention of patients on treatment.
Two thousand five hundred fourteen patients with active convulsive epilepsy were enrolled. After more than 1 year of treatment, 78.4% of the patients had a 50% or greater reduction in seizure frequency and 43.3% remained seizure free. Probability of retention was 85.8% at 750 days. Nearly 20% patients withdrew from the project, and most of them migrated out of the study areas. Some regular training and educational programs were also carried out.
This pragmatic procedure suggests that the network could be suitable for managing convulsive epilepsy in resource-poor regions. Such a network could depend on existing primary health services to ensure its sustainability.
建立中国西部农村地区癫痫患者管理网络的运作模式。
该网络由公共卫生行政部门统一领导，与医疗机构和疾病预防控制组织联系，培养当地社区参与。癫痫患者使用苯巴比妥治疗。经过培训的基层初级卫生保健医生进行筛查、治疗和随访。通过网络逐步提供政治、财政和技术支持。疗效评估为癫痫发作频率降低的百分比和治疗保留的患者比例。
共纳入 2514 例活动性癫痫患者。经过 1 年以上的治疗，78.4%的患者癫痫发作频率降低 50%或以上，43.3%的患者无癫痫发作。750 天时保留率为 85.8%。近 20%的患者退出了该项目，其中大多数人已迁出研究地区。还开展了一些常规培训和教育计划。
这种实用程序表明，该网络可能适用于资源匮乏地区的癫痫管理。该网络可以依靠现有的初级卫生服务来确保其可持续性。
