喉返神经不同程度损伤所致神经电图变化

Nerve electrogram study on different degrees injuries of recurrent laryngeal nerve

目的：研究不同程度喉返神经损伤在神经电图上的表现。方法：用动物实验模拟喉返神经颈段常见的几种损伤类型，如牵拉、钳夹、电灼、切断等，通过神经电图检测得各组喉返神经的潜伏期及振幅。结果：不同损伤喉返神经测得的潜伏期及振幅分别为，牵拉：（2．43±0．32）ms、（0．95±0．23）mV；钳夹：（2．99±0．55）ms、（0．62±0．22）mV；电灼：（4．85±1．03）ms、（0．24±0．15）mV；切断；∞ms、0mV。结论：喉返神经损伤后在神经电图上潜伏期及振幅变化是有规律的，即潜伏期的长短与损伤程度成正比，振幅大小与损伤程度成反比，喉返神经损伤以牵拉、钳夹、电灼及切断依次加重。本法可考虑用于甲状腺手术中作为一种监测神经的方法及判断神经损伤的预后。

To study the display of different degrees injuries of recurrent laryngeal nerve in electroneurogram. Method: We imitated several common types of injuries i. e stretch,claming,electrocautery and cut in cervial segmemt of recurrent laryngeal nerve and measured latency and amplitude of the nerve by electroneurography. Result: The normal value of latency was (1. 58±0. 14 )ms and that of amplitude was (2.53±0. 78 )mV; stretch group was (2. 43±0. 32)ms and (0. 95±0. 23)mV; claming group was (2. 99±0. 55 )ms and (0. 62±0. 22)mV; electrocautery group was (4. 85±1. 03 )ms and (0. 24±0. 15 )mV;cut group was ∞ ms and 0 mV. Conclusion: Latency correlated directly with the degree of nerve injury. Whereas amplitude correlated inversely with the degree of nerve injury. Stretch injured recurrent laryngeal nerve the least,followed by claming, electrocautery and cut. This method could be used for nerve monitoring during operation and prognostic judgement.