目的:探讨康复精细化管理对脑卒中偏瘫患者上肢功能和日常生活活动能力(ADL)的影响。方法:脑卒中偏瘫患者48例随机分为2组各24例,2组均采用常规的康复治疗和护理,对照组采取随意安排床位及常规的病床管理,观察组根据患者偏瘫个体化特点安排病房病床、病床配套设备、相应精细化处置方法等,并安排康复护士进行24h康复护理巡回。结果:干预1个月后,2组FMA各项评分均较治疗前有所提高,但差异无统计学意义;干预3及6个月后,2组FMA各项评分均较治疗前明显提高(均P<0.01)。观察组的屈肌协同能力评分在干预1、3及6个月时均明显高于对照组(均P<0.01),观察组的伴协同运动和脱离协同运动评分在干预后6个月均明显优于对照组(均P<0.05)。干预6个月后,2组BI评分均较治疗前明显提高(均P<0.05),且观察组高于对照组(P<0.05)。结论:康复精细化管理有利于促进脑卒中偏瘫患者ADL及部分上肢运动功能的提高。 Objective: To investigate the effect of rehabilitation and fine management on upper extremity function and activities of daily living (ADL) in patients with hemiplegia after stroke. Methods: Forty-eight stroke patients with hemiplegia were randomly divided into two groups of 24 patients. The two groups were treated by conventional rehabilitation and nursing. The control group was randomly assigned to bed and conventional bed management. The observation group was arranged according to individual characteristics of patients with hemiplegia Bed, bed equipment, the corresponding fine processing methods, and arrange rehabilitation nurses for 24 hours rehabilitation nursing tour. Results: After 1 month of intervention, the score of FMA in both groups was higher than that before treatment, but the difference was not statistically significant. After intervention for 3 and 6 months, the scores of FMA in both groups were significantly higher than those before treatment All P <0.01). The scores of flexor coordination ability in the observation group were significantly higher than those in the control group at 1, 3 and 6 months (all P <0.01), and those in the observation group were significantly higher at 6 months after intervention Better than the control group (all P <0.05). After intervention for 6 months, the scores of BI in both groups were significantly higher than those before treatment (both P <0.05), and the observation group was higher than the control group (P <0.05). Conclusion: Rehabilitation fine management is helpful to promote ADL and some upper extremity motor function in stroke patients with hemiplegia.