正常喉诱发电位特点的研究  

Characteristics of normal laryngeal nerve evoked potentials

作　　者：侯丽珍[1] 徐文[1] 韩德民[1] 张丽[1] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,100730

出　　处：《中华耳鼻咽喉头颈外科杂志》2007年第3期207-210,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：北京市科技新星项目资助(H020821190190)

摘　　要：目的分析正常喉肌诱发电位特点,得出其参数正常参考值范围,以利于喉神经功能的评估。方法检测36例健康受试者72侧喉诱发电位反应,刺激相应喉返神经、喉上神经内、外支及迷走神经,检测诱发肌电反应潜伏期、时程、波幅(电位)。结果甲杓肌喉返神经诱发肌电潜伏期正常参考值(±2s,以下同)为(1.13～2.25)ms,迷走神经诱发肌电潜伏期(2.57～5.85)ms,迷走神经与喉返神经潜伏期相比差异有统计学意义(P<0.01);其中右侧迷走神经诱发肌电潜伏期(2.01～4.53)ms,左侧迷走神经(3.70～6.98)ms,双侧比较差异有统计学意义(P<0.01),左侧明显较右侧长。诱发肌电时程和波幅各神经亦略有差异,时程差异较小,波幅值变化较大。刺激喉上神经(外支)在环甲肌可直接引出诱发电位,其波形和潜伏期与喉返神经诱发电位大致相同,刺激喉上神经(内支)在甲杓肌、环杓侧肌和环杓后肌可引出反射性感觉诱发电位前波 R1和迟发波 R2。结论喉各支配神经诱发电位特点各不相同;神经诱发电位的潜伏期相对时程和波幅来说,是更重要的评估参数。Objective To study the behaviors of normal recurrent laryngeal nerve and superior laryngeal nerve evoked eleetromyography, to know the reference values of related parameters. Methods Thirty six normal subjects were studied with laryngeal evoked electromyography. The latent period, duration, and amplitude of the evoked potentials （EP） recorded in laryngeal muscles were investigated. Results The latent period of the EP recording from the thyroarytenoid muscles （ TA）, after stimulating recurrent laryngeal nerve （ RLN）, was （ 1.13 - 2. 25 ） ms （ x^-± 2s）, that of TA after stimulating vagus nerve （VN） was （ 2. 57 - 5.85） ms. There were significant differences in the latent periods of EP between RLN and VN（ P 〈 0. 01 ）, and the latent periods of EP recording from TA after stimulating right cervical part of VN, （2. 01 -4. 53 ） ms （x^-±2s） were significant shorter than those of left, （ 3.70,6. 98） ms （x^-±2s, P 〈 0. 01 ）. The durations of the EP were somewhat different but not significant. The amplitudes of the EP in different laryngeal muscles changes markedly. The wave form and latent period of the EP recording from cricothyoid muscle （ CT）, after stimulating the external branch of superior laryngeal nerve （ SLN）, was similar with the EP of RLN, the reflective EP R1 and R2 could be recorded from TA, posterior cricoarytenoid muscles （ PCA）, CT after stimulating the internal branch of SLN. Conclusions The characteristics of the EP recorded in laryngeal muscles after stimulation of RLN, SLN and VN are different. The latent period, duration and amplitude are important parameters in the evaluation of laryngeal nerves function, the latent period is the most important parameter.

关 键 词：喉返神经 喉神经 诱发电位 肌电描记术 参考值 

分 类 号：R767[医药卫生—耳鼻咽喉科]