选择性喉返神经吻合术治疗喉麻痹的实验研究

Selective Recurrent Laryngeal Nerve Anastomosis in the Treatment of Laryngeal Paralysis

目的 研究不同神经源分别支配受损喉返神经内收及外展肌支的神经肌电表现。方法 将实验组犬左喉返神经完全切断 ,再将其外展肌支及内收肌支分别同期与同侧膈神经支及颈袢胸舌肌支吻合 ,吻合术后 6个月分别用神经电图仪、光镜、电镜及直达喉镜等方法全面检测甲杓肌与环杓后肌神经肌电活动情况 ,所得数据用统计学方法进行分析。结果 吻合术后 6个月 ,喉内收及外展肌均出现动作电位波 ,其甲杓肌潜伏期与术前比较无差异 ,甲杓肌神经传导速度已恢复正常 ,环杓后肌神经传导速度稍慢。结论 选择性喉返神经吻合术最大限度地从生理及解剖上避免了吻合术后喉内肌的联带运动问题 。

Objective To study the electro-neurogram of reinnervation between recurrent laryngeal nerve and two other different nerves.Methods The abducent and adducent branches of the recurrent laryngeal nerve were dissected and anastomosed with the branches of phrenic and cervical ansa respectively. Six months after the operation, the electro-neurogram was used for the analysis of the function of thyroarytenoid (TA) muscle and posterior cricoarytenoid (PCA) muscle.Results Six months after the operation, both abducent and adducent laryngeal muscle showed the action potential waves, the nervous latency was nearly normal, the nervous conduction speed of the PCA was reduced but that of the TA was normal.Conclusion Physically, the type of this operation can mostly avoid the laryngeal synkinesis, it reaches the anticipated aim.