失神经喉内肌纤颤电位波幅的变化及临床意义

Clinical significance and changes of fibrillation potential amplitude following denervation of laryngeal muscles

目的：评估喉肌电图中纤颤电位波幅测定的临床应用价值。方法：对54例（共65侧）喉返神经麻痹患者的甲构肌、环构后肌行肌电图检查，记录最大纤颤电位波幅。结果：不同性别、年龄及不同侧的纤颤电位波幅间的差异无显著性，失神经环构后肌纤颤电位波幅均值在病程2～＜4个月时最高，而失神经甲构肌纤颤电位波幅均值在病程4～＜6个月时最高，相当一部分患者的纤颤电位波幅晚期仍维持一定水平，并且神经完全损伤者和不完全损伤者各时间纤颤电位波幅均有显著性差异，而神经不完全损伤者各时间幅度变化小。结论：纤颤电位波幅可成为一个反映肌肉萎缩是否可逆的潜在指标，其应用较传统纤颤电位检查法更具科学性。

To evaluate the value of clinical application of examination of fibrillation potential amplitude of laryngeal electromyogram. Method: Fifty-four patients (65 sides ) with recurrent laryngeal nerve paralysis were examined and only the maximum fibrillation potential amplitudes were recorded in the posterior cricoarytenoid muscles and thyroarytenoid muscles. Result: There was no significant difference between sexes, ages and sides. The fibrillation potential amplitude was maximum at 3 to 4 months after denervation of the posterior cricoarytenoid muscle or at 5 to 6 months after denervation of the thyroarytenoid muscle and still remained at certain level for years in some patients. Significant difference was showed in complete and incomplete nerve injuries groups, but changes of amplitude with time in incomplete nerve injuries group were small. Conclusion: The changes of fibrillation potential amplitude might indicate that the changes from muscle denervation was still reversible and might be more accurate than traditional method of examination.