肌电图检查判定上睑提肌功能的临床价值

Clinical significance of ophthalmo—electromyography in the determination of the function of the superior levator muscle.

采用丹麦产 Neuermatic 2000型肌电图仪对36例上睑下垂患者于术前进行了上睑提肌肌电图检查,旨在寻找一种能够反映上睑提肌功能状态的方法。结果表明:12例轻度上睑下垂患者重收缩时峰值电压均在30mv 以上,其中以峰值电压为100mv 以上效果最佳。在24例中重度上睑下垂患者中,重收缩时图形大部分为单纯相、低振幅。手术均采用内外路结合的上睑提肌缩短手术,峰值电压在30mv 以下的9例术后睑裂未达到预想高度,而峰值电压在30mv 以上的15例术后效果满意。认为:中、重度上睑下垂患者的术式选择应以术前肌电图检查为依据,如果上睑提肌重收缩时峰值电压为30mv 以上,则可行上睑提肌缩短术;如峰值电压<30mv,且图形呈单纯相或电静息,则选择额肌悬吊类手术。

Preoperative electromyographic examinations of superior levator muscle were done in 36 ptotic patients using the Neurematic 2000 electromyograph.Shortening of the levator palpebrae superior was done through a combined internal and external route.In 12 patients of mild ptosis the spike voltage was all above 30mv during contraction.When the spike voltage was above 100my,better operative re- sults were obtained.In 24 patients whose ptosis was moderate or severe,the graphs of contraction gen- erally showed simple phases with low amplitude.In 9 patients whose spike voltage was below 30mv, their palpebral fissure did not reach the anticipated width after the operation.On the contrary,in 15 pa- tients whose spike voltage was above 30my the operative results were satisfactory.It is concluded that in patients whose ptosis is moderate or severe,the operative procedure should be based on electromyo- graphic examinations.If the spike voltage of the superior levator muscls is higher than 30mv on contrac- tion,simple shortening of the levator will be successful.If the spike voltage is lower than 30my and the graph presents simple phase or electro- tranquilization,then suspension of the frontalis muscle is preferable.