喉部超声在脑卒中后声带麻痹评价中的应用  

Evaluation of Vocal Cord Paralysis after Stroke with Laryngeal Ultrasound

作　　者：武静芳[1] 李雪梅[1] 袁永学[2] WU Jing-fang;LI Xue-mei;YUAN Yong-xue(Department of Ultrasound, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China;Department of Speech and Hearing Therapy, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China)

机构地区：[1]中国康复研究中心北京博爱医院,超声科,北京市100068 [2]中国康复研究中心北京博爱医院,听力语言科,北京市100068

出　　处：《中国康复理论与实践》2019年第7期766-770,共5页Chinese Journal of Rehabilitation Theory and Practice

基　　金：中央级公益性科研院所基本科研业务费专项资金项目(No.2015CZ-16)~~

摘　　要：目的观察喉部超声临床评价脑卒中患者声带麻痹的价值.方法 2017年1月至2019年3月,脑卒中后出现声音嘶哑的患者41例,完成喉部超声检查后立即行喉镜检查,观察声带在平静呼吸状态和患者发/a/音时,声带位置,声带内收、外展运动,进行声带运动分级,Ⅱ级以上为声带麻痹.比较两种方法的符合率.结果 82个侧别中,两种检查结果完全一致的78侧,符合率95.1%;不一致主要出现在双侧声带麻痹患者中,共2例.1例喉镜提示声带右侧Ⅲ级、左侧Ⅱ级,超声提示右侧Ⅲ级、左侧Ⅰ级;1例喉镜提示声带右侧Ⅲ级、左侧Ⅱ级,超声提示右侧Ⅱ级、左侧Ⅲ级.以喉镜诊断为金标准,超声诊断特异性97.1%,敏感性85.7%;Kappa值为0.911,P<0.001.结论喉部超声可以用于评价脑卒中引起的声带麻痹.Objective To evaluate the vocal cord movement after stroke with laryngeal ultrasound. Methods From January, 2017 to March, 2019, 41 patients with stroke following hoarseness were examined with laryngeal ultrasound and direct laryngoscope. The movement was graded from I to III, in which grades II and III were considered as vocal cord paresis or palsy. The results under ultrasound were compared to laryngoscope (gold standard). Results For 82 sides vocal cords in 41 patients, 78 sides were consistent grading between laryngeal ultrasound and laryngoscopy, and the coincidence rate was 95.1%. The difference was mainly found in patients with bilateral vocal cord paralysis, two cases in total. Under ultrasound, one case was graded Ⅲ(right) and Ⅰ(left), and the other was graded Ⅱ(right) and Ⅲ(left);while under laryngoscopy, they were graded as Ⅲ(right) and Ⅱ(left), and Ⅲ(right) and Ⅱ(left), respectively. The specificity of ultrasound was 97.1%, and sensitivity was 85.7%, respectively. Kappa = 0.911, P < 0.001. Conclusion Laryngeal ultrasound can be used for the diagnosis and evaluation of vocal cord movement after stroke.

关 键 词：脑卒中 声带麻痹 喉部超声 

分 类 号：R493[医药卫生—康复医学]