喉返神经端端吻合术疗效的评价研究

An Evaluation on Repair Recurrent Laryngeal Nerve Injuries by end-to-end anastomosis in Rats

目的 :评价喉返神经端端吻合术的疗效。方法 :15只SD大鼠被分为二组 ,实验组 (10只 )为喉返神经端端吻合组 ,切断右侧喉返神经后立即行神经端端吻合。正常组 (5只 )仅暴露喉返神经后不再做其他处理。术后 1、3个月利用神经肌电图评价神经再生情况 ,利用纤维喉镜观察声带活动情况。结果 :术后 1、3个月 ,实验组神经肌电图显示再生神经的潜伏期及振幅与正常组相比无显著性差异 (P>0 0 5 )。术后 1个月 ,纤维喉镜检查发现 1只声带恢复正常运动 ,6只声带中度活动 ,2只声带轻度活动 ,1只声带固定不动。术后 3个月 ,纤维喉镜检查发现 1只声带恢复正常运动 ,7只声带中度活动 ,1只声带轻度活动 ,1只声带出现矛盾运动。结论 :该术式是修复喉返神经损伤较为实用的方法之一。神经肌电位出现的时间早于声带活动 ,即先有神经肌电位出现 ,然后才望出现声带活动。神经肌电图正常并不意味着声带活动正常 ,评价喉返神经修复手术效果最可靠的标准是纤维喉镜检查。

Objective: To evaluate the effect of end to end nerve anastomosis to repair recurrent laryngeal nerve(RLN) Methods: 15 SD rats were divided into two group,In experimental group(n=10)right RLN were incised and anastomosed sutured immediately by means of end to end nerve anastomosis In normal group rats were only exposed RLN and not treated by any elements One to three months later,rats were examined for vocal cord movement and nerve regeneration by using fibrolaryngscope and nerve electrormyography Result: One and three months after operation,Nerve electromyography indicated that nerve latency and amplitude had no significant difference compared with normal group(P>0 05) One months after operation,1 rats10 rats were found that had normal vocal cord movement;6 rat moderate,2 rats slight,1 rat stabile Three months after operation,1 rats of the 10 rats were found that had vocal cord movement,7 rat moderate,1 rats slight,1 rat contridictory vocal cord movement Conclusion: End to end nerve anastomosis is an effect way to repair RLN The emerging time of nerve electromyography is earlier than that of vocal cord movement Normal nerve electromyography does not mean normal vocal cord movement Fibrolaryngscope examination is the most important and reliable standard to evaluate the effect of surgery [