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目的 观察早期综合康复治疗对脑梗死偏瘫患者上肢功能及临床疗效的影响.方法将2015年1月~2016年12月收治的106例脑梗死后偏瘫患者随机分为观察组和对照组各53例.两组均给予抗血小板聚集、脑保护和抗凝等常规治疗.观察组在病情稳定48 h 内给予综合康复治疗,包括良姿摆放、运动训练、MOTO智能训练、针灸、功能性电刺激治疗及心理干预等,30 d后评估患者Fugl-Mey-er运动功能评分、Barthel指数、肩手综合征发生情况及临床疗效.结果 治疗30 d 后,观察组患者 Fugl-Meyer上肢功能评分 (25.9 ± 8.2vs.21.7 ± 6.5) 和Barthel指数 (43.6 ± 9.5vs.37.9 ± 8.4) 均显著高于对照组 ( t =2.922,P =0.004;t =3.272,P =0.001 );观察组肩手综合征发生率显著低于对照组 (1.9% vs.13.2%) ( χ2= 3.975,P = 0.046 );两组总体疗效差异显著 ( Z = 2.126,P = 0.034 ),观察组总有效率高于对照组 (96.2% vs.90.6%),但此差异无统计学意义 (P=0.437).结论 早期综合性康复治疗可显著改善脑梗死偏瘫患者上肢功能,预防肩手综合征,有助于减轻神经功能缺损.“,”Objective To observe the effect of early comprehensive rehabilitation therapy on upper limb function in hemi-plegia patients after cerebral infarction. Methods 106 cases from January in 2015 to December in 2016 were enrolled and randomly divided into the observation group (n=53) and the control group (n=53). The two groups received anti platelet aggregation, cere-bral protection, anticoagulation and other conventional treatment. And the observation group accepted comprehensive rehabilitation within 48h after stable condition, including good posture places, ports training, MOTO intelligence training, acupuncture, function-al electrical stimulation and psychological intervention. Fugl -Meyer function score, Barthel index, shoulder hand syndrome and clinical efficacy in the two groups were determined and compared at 30 days after the treatment. Results At 30 days after the treat-ment, Fugl-Meyer score of upper limb function (25.9 ± 8.2vs.21.7 ± 6.5) and Barthel index (43.6 ± 9.5vs.37.9 ± 8.4) in the observation group were significantly higher than those in the control group ( t =2.922,P =0.004;t =3.272,P =0.001). The inci-dence of shoulder hand syndrome in the observation group was significantly lower than that in the control group (1.9% vs.13.2%) ( χ2= 3.975,P = 0.046). There were significantly difference in the efficacies in the two groups ( Z = 2.126,P = 0.034). Total efficiency ratio in the observation group was higher than that in the control group (96.2% vs.90.6%). There was no statistically sig-nificant differeence ( P =0.437). Conclusion Early comprehensive rehabilitation therapy can significantly improve the upper limb function of hemiplegic patients after cerebral infarction, prevent shoulder hand syndrome and help to reduce neurological deficit.