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目的对脑梗死患者通过有效的康复训练,探索脑梗死后运动功能康复的最大效能,以其找到脑血管病的最佳治疗方案。方法所有患者均行常规神经内科治疗,其中康复治疗组31例,对照组12例,分别于患病后3d、21d及6个月后,行经颅大脑皮质电刺激(MEP)检查,记录电极置于双侧拇短展肌,记录MEP的潜伏期、波幅及中枢传导时间(CMCT),探索患者康复治疗后脑运动功能可塑性的量化指标。结果通过设置的对照组以排除脑功能的自然可塑性,对研究组采用Bobath和运动再学习疗法的内容相结合进行训练后,康复组在神经功能缺损程度、上肢功能、日常生活能力及MEP的量化指标和对照组相比,有显著性差异,且脑梗死患者的MEP异常程度与临床症状、梗死部位和范围密切相关。结论通过有效的康复训练能使脑梗死后脑运动功能可塑性达最佳化,是一种行之有效的治疗手段,而MEP是评价脑梗死后脑运动功能可塑性及预后的一种有效量化方法,可在临床上普及推
Objective To explore the maximal efficacy of rehabilitation of motor function after cerebral infarction through effective rehabilitation training for patients with cerebral infarction and find the best treatment plan for cerebrovascular disease. Methods All patients underwent routine neurological treatment. Among them, 31 patients in the rehabilitation group and 12 patients in the control group were examined by transcranial cortical electrical stimulation (MEP) at 3d, 21d and 6 months after the onset of illness, respectively. At the bilateral hallux extensors, the latency, amplitude and central conduction time (CMCT) of MEP were recorded, and the quantitative indexes of plasticity of brain motor function after rehabilitation were explored. Results By setting the control group to exclude the natural plasticity of brain function and training the study group using Bobath and exercise re-learning therapy, the rehabilitation group had significant differences in neurological deficit, upper extremity function, daily living ability and MEP quantification Compared with the control group, there were significant differences between the two groups. The degree of MEP abnormalities in patients with cerebral infarction was closely related to clinical symptoms, infarct size and range. Conclusion Effective rehabilitation training can optimize the plasticity of cerebral motor function after cerebral infarction, which is an effective treatment method. MEP is an effective quantitative method to evaluate the plasticity and prognosis of cerebral motor function after cerebral infarction. Popularization of clinical push