Xu L, Wu D P, Li Y, Zhang L, Wang Y, Wang Q Y, Liu M Q, Wu X D, Hong Z
Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China.
School of Communication Engineering, Hangzhou Dianzi University, Zhejiang 310018, China.
Zhonghua Yi Xue Za Zhi. 2020 Dec 22;100(47):3764-3767. doi: 10.3760/cma.j.cn112137-20200703-02023.
To provide a portable electroencephalograph that can facilitate long-term monitoring of epilepsy patients outside the hospital, and establish a medical platform for epilepsy data monitoring and treatment. From June 2018 to October 2019, twenty-nine patients from Huashan Hospital (superior hospital) and Jing'an District Central Hospital (subordinate hospital) of Fudan University were enrolled in the study. Among them, twenty-eight cases were diagnosed with epilepsy and 1 case was epileptic seizure. Electroencephalogram (EEG) was collected by portable electroencephalograph once a week and followed up for three months. The seizure frequency, seizure form, medication type, EEG lead number and positive rate were recorded. Patients' medical records and EEG data were uploaded to the cloud database to build a medical alliance platform. Doctors of different levels of hospitals couldobtain diagnosis and achieve resource sharing based on the platform. The data was statistically analyzed using SPSS 18.0. The EEG data collected by the portable electroencephalograph hadfewer artifacts, complete sleep cycle, and could record the interictaldischarges. Twenty-nine patientsunderwent a total of 148 EEG monitoring during the three-month follow-up. Eighty-five cases of epileptic discharges were detected, and the EEG positive rate was 57.4%. The positive rate of EEG in patients with generalized seizures (84.9%) was higher than that in patients with focal seizures (42.1%) (0.01); the positive rate of EEG in patients with 2-3 antiepileptic drugs and patients with frequent seizures within three months were also higher (0.05). Doctors in the superior hospital in the platform make diagnosis and treatment suggestions according to the above data. Elevenseizure-free patients and four patients with fewer seizures and discharges were diverted to the community hospital for follow-up. Fourteen patients with poor seizure control and/or continuous epileptic discharges were diverted to the superior hospitalto adjust the medication. Doctors of subordinate hospital acquired the diagnosis and treatment suggestions through the platform, and then strengthened the daily care and follow-up. Combined with a portable electroencephalograph, the current study establishs a medical platform for patients with epilepsy to achieve long-term monitoring and rational use of medical resources.
为提供一种便于在院外对癫痫患者进行长期监测的便携式脑电图仪,并建立癫痫数据监测与治疗的医疗平台。2018年6月至2019年10月,复旦大学附属华山医院(上级医院)和静安区中心医院(下级医院)的29例患者纳入本研究。其中,28例诊断为癫痫,1例为癫痫发作。使用便携式脑电图仪每周采集1次脑电图(EEG),随访3个月。记录发作频率、发作形式、用药类型、EEG导联数及阳性率。将患者病历及EEG数据上传至云数据库,构建医疗联盟平台。不同级别医院的医生可基于该平台获取诊断并实现资源共享。采用SPSS 18.0对数据进行统计学分析。便携式脑电图仪采集的EEG数据伪迹较少,睡眠周期完整,可记录发作间期放电。29例患者在3个月随访期间共进行了148次EEG监测。检测到85例癫痫放电,EEG阳性率为57.4%。全身性发作患者的EEG阳性率(84.9%)高于局灶性发作患者(42.1%)(P<0.01);使用2 - 3种抗癫痫药物的患者及3个月内发作频繁的患者EEG阳性率也较高(P<0.05)。平台上级医院的医生根据上述数据提出诊断和治疗建议。11例无发作患者及4例发作和放电较少的患者被转至社区医院进行随访。14例发作控制不佳和/或持续癫痫放电的患者被转至上一级医院调整用药。下级医院的医生通过平台获取诊断和治疗建议,进而加强日常护理和随访。结合便携式脑电图仪,本研究建立了癫痫患者医疗平台以实现长期监测和合理利用医疗资源。