肌电图检查对声带麻痹预后的评估

目的 :探讨喉肌电图检查对声带麻痹预后的评估作用。方法 :对 4 6例单侧声带麻痹且固定的患者行甲杓肌的自发肌电图检查 ,分析甲杓肌失神经电位及运动单位波形、时程、电位幅度及运动单位平方根 (RMS)值 ;喉镜观察声带运动恢复情况。结果 :病程在 6个月以内 ,肌电图出现正常的运动单位波形、无电静息 ,提示预后较好 ,判断准确率为 76 % ;RMS值在用力发音时大于 2 6 μV ,提示声带运动可恢复 ,判断准确率为 80 %。综合两者 ,判断准确率为 84 %。声带麻痹 6个月以上者 ,无论肌电图检查结果如何 ,声带运动均无恢复。运动单位时程及电位幅度对判断预后价值不大。结论 :将喉肌电图定性指标与RMS值进行综合分析 ,可提高对声带麻痹预后判断的准确率

The prognostic role of electromyography in vocal cord paralysis

OBJECTIVE: To predict the recovery of vocal cord paralysis (VCP) by using electromyography (EMG). METHOD: The characteristics of EMG of 46 patients with unilateral VCP were assessed to determine the most useful factors in determining prognosis. The factors include the duration, amplitude, waveform morphology, root-mean-square, and time interval. RESULT: A positive prognosis for laryngeal recovery was indicated when the following EMG features were present in the immobile vocal fold during voluntary tasks if EMG was performed during 6 months of the onset of VCP: normal motor unit waveform morphology; no electrical silence. This predictive rate is 76%. When the root-mean-square value is greater than 26 microV, the predictive rate is 80%. On the basis of the criteria, all the prognostic rate is 84%. CONCLUSION: The results support the concept that EMG record is valuable in determining prognosis performed during 6 months of the onset of VCP.