喉肌电图与喉肌诱发电位在颈前路术后喉返神经麻痹中的评价作用

Clinical application value of laryngeal electromyography and laryngeal somatosensory evoked potential in patients with recurrent laryngeal nerve paralysis by anterior elective cervical surgery

目的:探讨喉肌电图(LEMG)和喉诱发电位(LSEP)对外伤脊髓型颈椎病颈前路手术引起喉返神经损伤再生程度的评估作用。方法:将18例喉返神经麻痹患者分别在术后1、2、4周3个不同时点进行喉肌电特点的分析,并与18例正常受试者进行对比研究。结果:①发病1周时,受累喉肌可出现失神经电位;2周失神经电位增多,可见再生电位;4周后失神经电位渐少,再生电位渐多。②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。④与正常对照组比较各病程组波幅均降低,差异均有统计学意义(P<0.05)。结论:喉肌电图和喉诱发电位对预测喉返神经麻痹预后有一定价值,可较准确地评估颈前路手术喉返神经损伤再生程度。

Objective：To determine the clinical evaluation role of laryngeal electromyography （LEMG） and laryngeal somatosensory evoked potential （LSEP） in the recurrent laryngeal nerve paralysis by anterior elective cervical surgery. Methods： LEMG and LSEP were determined in 18 patients with recurrent laryngeal nerve paralysis by anterior elective cervical surgery at the 1st, 2nd and 4th week after operation. The comparison between the normal control （18 health adults） and the results of LEMG and LSEP were analyzed. Results ：The latency prolonged and the amplitude decreased of LSEP in all patients as compared with the control group.Furthermore, reinneration potential increased gradually in all patients at the 1 st, 2nd and 4th week after operation（P〈0.05 ）. The results of LEMG showed increase of denervation potential. The higher the amplitude of LSEP and LEMG, the better the prognosis of the recurrent laryngeal nerve paralysis. Conclusion ： LEMG and LSEP might evaluate regenerate the degree of recurrent laryngeal nerve injury caused by anterior elective cervical surgery and predict the prognosis of the recurrent laryngeal nerve paralysis.