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目的:本研究拟提供一套方便癫痫患者进行院外长期监测的便携式脑电图设备,从而建立一个用于癫痫数据监测与联合诊疗的医联体平台。方法:纳入2018年6月至2019年10月来源于复旦大学附属华山医院(上级医院)和附属静安区中心医院(下级医院)癫痫中心门诊的29例患者,其中确诊癫痫28例,痫样发作1例。使用便携式脑电图仪采集脑电图,每周采集一次,随访3个月。记录发作次数、发作形式、用药种类、脑电图导联数及阳性率。患者病历资料及脑电数据通过网络上传存储至云端数据库,构建医联体平台,不同级别医院的医生可基于该平台实现对癫痫患者数据的分级诊断和资源共享。结果:便携式脑电图仪采集的脑电数据伪迹较少,可以监测到完整的睡眠周期,且能记录到发作间期痫样放电。29例患者在3个月随访期间共进行148次脑电图监测,监测到发作间期痫样放电85例,脑电图阳性率为57.4%。全面性发作患者的脑电图阳性率(84.9%)较局灶性发作者更高(42.1%)(n P<0.01);使用2~3种抗癫痫药物的患者,及3个月内发作次数频繁的患者,脑电图阳性率也更高(n P<0.05)。医联体平台中的上级医院医生根据发作情况和脑电数据作出诊疗建议:11例无发作患者及4例发作与脑电图均改善的患者,分流至下级医院继续随访;14例发作控制不佳和(或)脑电图持续痫样放电的患者,转诊至上级医院调整用药。下级医院的医护人员通过医联体平台查看诊疗建议,加强对患者的日常护理及随访。n 结论:结合便携式脑电图仪,本研究建立了一个针对癫痫患者的医联体平台,从而达到长期监测和合理利用医疗资源的目的。“,”Objective: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.Methods: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.Results: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%) (n P<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 (n P<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.n Conclusion: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.