目的：探讨应用三维（three dimension,3D）打印分指板对脑卒中早期患者手指痉挛及其康复疗效。方法：选取90例脑卒中手功能障碍患者,按照随机数字表法分为3D打印组、传统组及对照组3组。分别给予个性化制作的3D打印分指板治疗、工厂批量生产的传统分指板治疗及常规良肢位摆放治疗。在基线及治疗3个月后,分别评估患者表面肌电图（surface electromyography,sEMG）手指屈肌群被动均方根（root-mean-square,RMS）值、改良阿什沃思量表（modified Ashworth scale,MAS）、Fugl-Meyer评定上肢（Fugl-Meyer assessment upper extremity, FMA-UE）、手指关节活动度（掌指、近端指间、远端指间）、改良巴塞尔指数（modified Barthel index,MBI）。结果：共有86例患者完成本研究,年龄59~79（70.92±4.75）岁,其中3D打印组29例,传统组28例,对照组29例。3组患者手指屈肌群被动RMS值、手MAS评级、FMA-UE及MBI均较治疗前差异有统计学意义（均P<0.001）,3组患者关节活动度（掌指、近端指间、远端指间）治疗前后差异无统计学意义（均P>0.05）。治疗3个月后,3组患者手指屈肌群被动RMS、MAS、FMA-UE、MBI指标差异有统计学意义（均P<0.05）, 3D打印组均优于传统组及对照组（均P<0.05）;但3组患者的关节活动度差异无统计学意义（P>0.05）。结论：早期使用3D打印分指板可有效预防脑卒中患者手指肌张力的升高和痉挛的发生,促进上肢运动功能恢复,改善患者日常生活活动能力。

Objective To explore the early use of three dimensional (3D) printing fingerboard to prevent finger spasm in the stroke patients and its rehabilitation effect. Methods Totally 90 cases of the stroke patients with hand dysfunction were divided into 3 groups according to random single-blind method, which included 3D printing group, traditional group and control group. They were treated with personalized 3D printing finger splint, traditional finger splint from factory mass production and conventional good limb positioning. Before starting treatment and after 3 months treatment, the patients’ surface electromyography(sEMG), passive root-mean-square(RMS) value of flexor finger group, modified Ashworth scale (MAS), Fugl-Meyer assessment upper extremity (FMA-UE), range of motion (metacarpal, proximal interphalangeal, distal interphalangeal), and modified Barthel index (MBI) were assessed. Results A total of 86 patients completed the study, and the age range were 59-79 (70.92±4.75) years, including 29 cases in 3D printing group, 28 cases in traditional group, and 29 cases in control group. The passive RMS value of finger flexor group, hand MAS rating, FMA-UE and MBI of 3 group patients were significantly different from those before treatment(all P<0.001). The joint range of motion of 3 group patients (march finger, proximal finger, far finger) had no statistical difference before and after treatment (all P>0.05). After 3 months treatment, the passive RMS, MAS, FMA-UE and MBI indexes of the finger flexors of 3 groups were statistically different(all P<0.05). Comparison among groups, the 3D printing group was better than traditional group and control group(both P<0.05); but there was no statistical difference in the range of motion among 3 group patients (P>0.05). Conclusions Early use of 3D printed fingerboards can effectively prevent increasing of finger muscle tension and spasm in the stroke patients, promote recovery of upper limbs motor functions, and improve patients’ activities of daily living.