肌电图检查估价声带麻痹预后的初步研究

A preliminary study of the prognostic role of electromyography in vocal cord paralysis

目的：探讨肌电图检查对声带麻痹预后的估价作用。方法：检测１３例完全单侧声带麻痹患者的自发肌电图运动单位时程、电位、波形及平方根值，喉镜观察声带运动恢复情况。结果：肌电图出现正常运动单位波形，无失神经电位及电静息者，提示预后较好，判断准确率为６７％；运动单位平方根值在发音及屏气时＞４０μＶ，病程在６个月以内者提示声带运动可恢复，判断准确率为８９％；声带麻痹６个月以上者，不论肌电图检查结果如何声带运动均无恢复，综合判断准确率可达９２％。运动单位时程及电位对判断预后的作用不能肯定。结论：将肌电图定性及定量的各指标进行综合分析可最大程度地提高判断声带麻痹预后的准确率。

Objective: To predict recovery of vocal cord paralysis ( VCP) using electromyography (EMG). Methods: The characteristics of EMG of 13 patients with unilateral VCP were assessed to determine which factor or combination of factors would be most useful in determining prognosis. The duration, amplitude, wave form morphology, root mean square, and time interval were examined from onset to EMG recording. Results: A positive prognosis for laryngeal recovery was indicated when the following EMG features were present in the immobile vocal fold if EMG was performed before 6 months of onset of VCP. (1) Normal motor unit waveform morphology and no fibrillations, this predictive rate being 67%. (2)Overall EMG activity characterized by a root mean square value greater than 40 μV in any one task, the predictive rate being 89%. (3) No electrical silence during voluntary tasks. Conclusion: The results support the concept that EMG recordings are valuable in determining prognosis.