神经肌蒂移植术治疗声带麻痹的对比实验研究  

A comparative study of different neuromuscular pedicle embeded in posterior cricoarytenoid muscle

作　　者：梁伟平[1] 吴平[2] 王正强[2] 陈贤明[3] 张德芳[4] 黄秀琴[5] 郑明秀[2] 

机构地区：[1]解放军第98医院耳鼻咽喉科,浙江湖州313000 [2]昆明医学院第二附属医院耳鼻咽喉科 [3]第四军医大学97博士队 [4]昆明医学院第二附属医院肌电图室 [5]昆明医学院组胚教研室

出　　处：《临床耳鼻咽喉科杂志》1999年第9期413-414,共2页Journal of Clinical Otorhinolaryngology

摘　　要：目的：比较不同神经肌蒂环杓后肌移植术治疗声带麻痹的疗效，为临床选择术式提供参考。方法：建立联合性喉麻痹模型，分别用颈袢胸骨舌骨肌肌蒂（简称颈袢组）和副神经胸锁乳突肌肌蒂（简称副神经组）移植于环杓后肌，以恢复声带外展功能。术后４ 个月，分别进行录音、直达喉镜和电视喉动态镜观察声带运动并录像，喉肌电图检查，环杓后肌透射电子显微镜检查和酶组织化学检查并进行电脑图像定量分析。结果：术后颈袢组和副神经组犬吠声均恢复正常，浅麻醉下直达喉镜和动态喉镜检查见双侧声带运动对称，喉肌电图检查均可从环杓后肌上记录到与呼吸同步的动作电位。组织化学及电子显微镜检查两组骨骼肌横纹清晰，神经纤维芽支再生明显，且已与环杓后肌建立了较多的运动终板，肌糖原正常。经统计学处理，两组间无显著性差异（ Ｐ ＞ ０．０５）。对照组肌纤维明显萎缩，肌纤维中几乎无运动终板。结论：神经肌蒂移植术是一种治疗声带麻痹切实有效的方法，颈袢组与副神经组两种术式均能使麻痹喉肌获得有效神经再支配。Objective:To compare the results and effect of different neuromuscular pedicle (NMP) embeded in posterior cricoarytenoid muscle.Method:In 22 dogs,combined vocal cord paralysis models were made. The first group (10 dogs) were embeded by sternohyoid muscle pedicle of ansa cervicalis, the second (10 dogs), accessory sternocleidomastoid neuromuscular pedicle, the third (2 dogs), control group. Result:Evaluation was possible in 19 dogs. Reinnervation of the left posterior cricoarytenoid muscle occurred in 17 dogs following NMP. Return of spontaneous abduction in the operated side with NMP was noted after 4 months postoperatively. There was little difference between the two NMP groups.Conclusion:NMP was successful to reinnervate the posterior cricoarytenoid muscle.

关 键 词：神经肌蒂移植 声带麻痹 实验研究 

分 类 号：R767.640.5[医药卫生—耳鼻咽喉科] R767.91[医药卫生—临床医学]