喉返神经麻痹的肌电特点及相关研究  

Study of laryngeal electromyographic behaviors of recurrent laryngeal nerve paralysis

作　　者：侯丽珍[1] 韩德民[1] 徐文[1] 张丽[1] 叶京英[1] 王军[1] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉科,北京100730

出　　处：《临床耳鼻咽喉头颈外科杂志》2007年第15期673-678,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：北京市科技新星资助项目(No:H020821190190)

摘　　要：目的：研究喉返神经麻痹患者不同时间和损伤程度的喉肌电特点。方法：根据发病时间将87例喉返神经麻痹患者分为7组,分析其喉肌电特点,并与30例正常受试者进行对比研究。结果：①发病2周时,最早5d在受累甲杓肌、环杓后肌和环杓侧肌即可出现纤颤波和正锐波等失神经电位;2周-3个月失神经电位增多,可见再生电位;3个月后失神经电位渐少,再生电位渐多;36个月后失神经电位消失。②受累喉肌肌电募集减弱甚至无明显干扰相,干扰相波幅和转折数显著低于正常对照组,其中转折数减低更为明显,未受累喉肌募集电位明显增大。③部分患者受累喉肌诱发电位消失,其他患者可见波幅小、潜伏期长的诱发电位。结论：喉肌电图对于喉返神经麻痹的诊断和鉴别具有重要意义,失神经电位和再生电位特点与神经损伤的程度和时间相关,异常的诱发电位可提示神经损伤的程度。Objective： To study the laryngeal electromyography （LEMG） behaviors of recurrent laryngeal nerve （RLN） paralysis at different time and severity level. Method：Eighty-seven cases with RLN paralysis were divided into seven groups according to their paralysis time. Their LEMG behaviors were investigated, and compared with normal. Result： （1）Fibrillation potentials and positive sharp wave could be found in injuried thyroarytenold muscles（TA）, posterior cricoarytenoid muscles（PCA）, lateral cricoarytenoid muscles（LCA） as early as five days after the onset of paralysis. The denervation potentials increased, and reinneration potentials appeared from two weeks to three months after the onset. The former abecame less and the latter increased from 3 months, and the denervation potentials vanished after three years. （2）The recruitment patterns of paralyzed muscles were weak and even there was no interference patterns in them. The amplitude and turns significantly decreased compared with normal control, and the decrease of the turns was more significant. The recruitment potentials of other normal laryngeal muscles increased right after the onset of disease. （3）Evoked potentials （EP） of most paralyzed laryngeal muscles vanished only in some patients, in others there were small and weak EPs, which had a longer latent period and small amplitude. Conclusion： LEMG is important for the diagnosis and differentiation of RLN paralysis. The denervationa potentials and reinneration potentials are important marks of RLN injury, and closely correlated with the degree and time of RLN injury. The abnormal EP of paralyzed laryngeal muscles could suggest the degree of injury.

关 键 词：喉返神经麻痹 肌电描记术 诱发电位 

分 类 号：R767.6[医药卫生—耳鼻咽喉科]