癫痫是一种由多种病因引起的慢性脑部疾病，其患者死亡风险为一般人群的2~3倍。我国农村地区，受多种因素的影响，约2/3的癫痫患者未得到合理的治疗，给患者及其家庭和社会带来沉重负担。顺德区积极响应“中国农村地区癫痫防治管理项目”，成立癫痫专科医联体，构建三级诊疗体系，开展了一系列实践探索。本文旨在总结顺德区专科医联体管理模式下的癫痫综合管理实践，分析管理现状，并提出改进路径，以期为癫痫患者提供更优质的服务，改善患者生活质量。

      Epilepsy is a chronic brain disorder caused by various etiologies，the mortality risk of epilepsy patients is 2 to 3 times higher than that of the general population．In rural areas of China，due to multiple influencing factors，approximately two-thirds of epilepsy patients receive inadequate or no proper treatment，imposing a heavy burden on patients，their families，and the society．Shunde District has actively responded to the “China Rural Epilepsy Prevention and Management Project” by establishing an epilepsy specialty medical consortium and building a three-tiered diagnostic and treatment system，conducting a series of practical explorations．This article aims to summarize the comprehensive epilepsy management practices under the specialty medical consortium model in Shunde District，analyze the current management status，and propose improvement strategies to provide better services for epilepsy patients and enhance their quality of life．

医联体是分级诊疗制度建设的重要抓手,对“健康中国”战略目标的实现具有重要作用。在当前医疗改革背景下,探究医联体建设模式具有重要意义。文章介绍了广州市属A医院和区属B医院探索的非托管紧密型医联体实践举措、成效、创新与不足,总结了该模式对我国医联体建设的启示：一是政府层面要做好顶层设计,给与政策支持;二是网顶医院要下沉优质资源,因地制宜帮扶;三是成员单位要主动参与建设,抓住发展机遇。

The establishment of medical unions is a crucial step in the development of a hierarchical diagnosis and treatment system and plays a significant role in achieving the strategic goal of “Healthy China．”Given the current context of healthcare reform,it is highly important to explore effective models for constructing medical unions．This paper introduces the practical measures taken by Guangzhou Hospital A and Hospital B to establish a non-trustee-close medical commonwealth．It discusses the effects achieved as well as innovations made through this approach while also highlighting its limitations．Furthermore,this study summarizes key insights that can be drawn from this model for building medical commonwealths in China：firstly,governments should focus on top-level design and provide policy support;secondly,leading hospitals should allocate high-quality resources based on local conditions;thirdly,member units should actively participate in construction efforts and seize development opportunities．

目的 探索老龄化形势下广州市白云区西部卒中防治工作的新模式。方法 通过完善组织结构、管理架构、建立稳定高效运行的(1+1+N)紧密型医联体模式,创建优质高效的卒中救治区域联盟,实现高质量的基层首诊,双向转诊,快速响应的卒中绿道急救和全程管理。结果 初步完成构建广州市白云区西部区域性卒中救治中心,区域内卒中患者及时救治,溶栓效率,血管再通等均有显著提升,整体提升白云区西部医疗机构的卒中救治水平。结论 区域性的协同救治是提高卒中救治水平的重要举措。(1+1+N)紧密型医联体模式能提高卒中患者救治率,具有可行性和必要性。

Objective To explore the effectiveness of a new stroke prevention and treatment pattern in the western part of Baiyun District, Guangzhou city, under an aging situation. Method We aim to build a high-quality and efficient stroke treatment regional alliance based on a (1+1+N) compact medical consortium, expecting to improve the overall abilities of stroke treatment in the western part of Baiyun District through high-quality primary care, two-way referrals, rapid response to stroke greenway emergency and full-process management. Results We have initially established a regional stroke treatment center in the western part of Baiyun District, Guangzhou. Stroke patients in that region can be treated in time, and the efficiency of thrombolysis and vascular recanalization have been significantly improved. Conclusion Regional coordinated treatment is an effective measure to reduce the disability and fatality rate of stroke. The (1+1+N) compact medical consortium model can improve the treatment effect in stroke patients, which is feasible and necessary.