喉肌电图在声带麻痹与环杓关节脱位疾病中的鉴别价值  

The diagnostic value of laryngeal electromyography in vocal fold paralysis and arytenoid dislocation

作　　者：虞鹏程 高楠 李旭茂 赵霞 孙广滨 YU Pengcheng;GAO Nan;LI Xumao;ZHAO Xia;SUN Guangbin(Department of Otorhinolaryngology Head and Neck Surgery, Huashan Hospital of Fudan University, Shanghai, 200040, Chin)

机构地区：[1]复旦大学附属华山医院耳鼻咽喉头颈外科,上海200040

出　　处：《临床耳鼻咽喉头颈外科杂志》2018年第6期420-423,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：上海市科学技术委员会科研项目(No:14DZ1942008)

摘　　要：目的:探讨喉肌电图在声带麻痹与环杓关节脱位患者中的鉴别价值。方法:分析比较36例声带麻痹和10例环杓关节脱位患者的病史、喉镜及喉肌电图特点。结果:声带麻痹患者的病因以手术损伤(24例)最常见,环杓关节脱位患者以气管插管史(9例)最常见。声带麻痹、环杓关节脱位组之间的受累声带和声带固定位置比较均差异无统计学意义。声带麻痹患者中,甲杓肌肌电图显示33例(91.67%)存在募集减弱或消失;9例失神经电位、8例再生电位出现于病程1~6个月内,3例(3/4)联带运动出现于病程>6个月。声带麻痹患者中,患侧甲杓肌波幅和转折数均低于健侧(P<0.01、P<0.05),双侧转折数/波幅比较差异无统计学意义;伴喉上神经损伤患者中,双侧环甲肌波幅-转折数分析差异无统计学意义。环杓关节脱位患者喉肌电图均显示正常。结论:喉肌电图对声带麻痹和环杓关节脱位患者可进行定性判断,同时也可进行定量分析,为明确诊断提供有价值的帮助。Objective：To identify diagnostic value of laryngeal electromyography（LEMG）in differentiating vocal fold paralysis（VFP）from arytenoid dislocation.Method：The history,laryngeal morphologic characteristics and LEMG of 36 patients with VFP and 10 patients with arytenoid dislocation were compared and analyzed.Result：The most common cause of 36 VFP patients was surgical damage（24 cases）,and the most common cause of 10 arytenoid dislocation patients was history of endotracheal intubation（9 cases）.There was no statistical difference between the vocal fold and the fixed position of the vocal fold between the group of VFP patients and arytenoid dislocation patients.In the patients with VFP,33 VFP patients（91.67%）had decreased recruitment;9 cases（9/13）of denervation potential and 8 cases（8/9）of regeneration potential occurred within 1-6 months of the course of disease;3 cases（3/4）of synkinesis occurred in the course of disease more than 6 months.In the patients with VFP,the amplitude（P〈0.01）and turns（P〈0.05）of thyroarytenoid muscles significantly decreased in the lesioned side comparing to the normal one,but the turns/amplitude ratio showed no statistical difference.In the patients with superior laryngeal nerve injury,the turns and amplitude analysis of cricothyroid muscles showed no statistical difference.All of 10 patients with arytenoid dislocation showed normal LEMG patterns.Conclusion：LEMG can be used to differentiate the patients with vocal cord paralysis from arthrodesis dislocation,and can also carry out quantitative analysis to provide valuable help for the diagnosis.

关 键 词：喉肌电图 声带麻痹 环杓关节脱位 

分 类 号：R767[医药卫生—耳鼻咽喉科]