双侧颈袢神经再支配环杓后肌电生理特性研究  

Electrophysiological characteristics of posterior cricoarytenoid muscle after bilateral reinnervations of anastomosing ansa cervicalis

作　　者：刘少锋[1,2,3] 葛平江[1,2] 张思毅[1,2] 祁周措[4] 姚丽明[4] 盛晓丽[1,2] 聂明荣[5] 

机构地区：[1]广东省人民医院 [2]广东省医学科学院耳鼻咽喉-头颈外科,广州市510008 [3]南方医科大学 [4]广东省人民医院,广东省医学科学院医学研究中心,广州市510008 [5]广州市儿童医院,510180

出　　处：《实用医学杂志》2010年第6期934-936,共3页The Journal of Practical Medicine

基　　金：广东省科技计划项目(编号:2008B030301171);广东省医学基金(编号:A2009007)

摘　　要：目的:将颈袢神经同喉返神经远心端吻合常常使用在重建喉肌功能的手术中,吻合后环杓后肌的电生理特性可能发生改变,我们为研究环杓后肌的电生理变化而做此研究。方法:14只混种狗被随机分为两组,一组动物暴露双侧喉返神经后,将其切断,立即将颈袢神经同其相吻合,为实验组。另一组动物为正常对照组。9周后,暴露吻合处,采用功能性电刺激刺激环杓后肌,并记录对应的声门开最大电刺激电压阈值和声门开大声带移动阈值。正常对照组同样测量这两个值。结果:实验组的声门开最大电刺激电压阈值是(4.86±1.46)V,声门开大声带移动阈值是(0.46±0.15)V,而正常对照组的两个值分别是(3.36±1.25)V和(0.39±0.21)V,两组间差异没有统计学意义(P>0.05)。结论:使用颈袢神经吻合喉返神经重建9周后,环杓后肌电生理特性较正常动物没有明显改变。提示使用较小的电刺激就能够促使颈袢神经重建的环杓后肌发生收缩,从而达到开大声门的作用。Objective To investigate the possible alterations of electrical physiology of posterior cricoarytenoid muscle （PCA） after anastomosing ansa cervicalis to distal recurrent laryngeal nerve （RLN）. Methods Fourteen mongrel dogs were randomized into 2 groups （n = 7）. RLN was immediately anastomosed to ansa cervicalis after removing bilateral RLN in test group. Normal animals were used as control group. Nine weeks later, RLN and PCA were exposed, and different voltage electrical stimulus were used to stimulate PCA. The threshold voltage was measured when the vocal fold reached max abduction and initial movement. Results The stimulus threshold voltages of vocal fold max abduction and initial movement were （4.86 ± 1.46）V and （0.46 ± 0.15）V in test group, （3.36 ± 1.25）V and（ 0.39 ± 0.21）V in control group. No significant difference exited between two groups. Conclusions Nine weeks after anastomosing ansa cervicalis to distal RLN, normal electrophysiological characteristics were kept in PCA. Compared with normal controls, few electrical stimuli on rebuilding PCA can cause similar vocal fold abduction.

关 键 词：电生理学 颈袢神经 环杓后肌 

分 类 号：R767[医药卫生—耳鼻咽喉科]