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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 electromyographic characteristics of patients with recurrent laryngeal nerve paralysis at different times and degrees of injury. Methods: According to the onset time, 87 patients with recurrent laryngeal nerve paralysis were divided into 7 groups. The laryngeal EMG characteristics were analyzed and compared with 30 normal subjects. Results: ① At 2 weeks after onset, the denervated potentials such as fibrillation wave and positive sharp wave appeared in the first 5 days after exposure to both the subtenillas, circumferior and posterior circumflex. The denervated potentials increased from 2 weeks to 3 months, Visible regenerative potential; 3 months after the denervation potential decreased, the regenerative potential gradually increased; 36 months after the loss of denervation potential. The involvement of EMG in the laryngeal muscle was weakened, even without significant interference phase, and the amplitude and number of disturbance phase were significantly lower than those in the normal control group. The reduction in the number of turns was more obvious, and the recruitment potential of the unaffected laryngeal muscle was significantly increased. ③ some patients affected by the disappearance of the induced potential laryngeal muscle, other patients showed small amplitude, long latency evoked potentials. Conclusion: Laryngeal electromyography is important for the diagnosis and differential diagnosis of recurrent laryngeal nerve paralysis. Denervation potential and regenerative potential are related to the degree and time of nerve injury. Abnormal evoked potentials can indicate the degree of nerve injury.