Title环杓侧肌肌电图用于喉返神经功能的术中评估
Other TitlesIntraoperative assessment of recurrent laryngeal nerve function by monitoring EMG of lateral cricoaryteoid muscle
Authors周刚
姜可伟
叶颖江
谢启伟
曲军
杨晓东
沈凯
郭鹏
王杉
Affiliation100044, 北京大学人民医院普通外科
Keywords甲状腺切除术
喉返神经
肌电描记术
环杓侧肌
术中神经监测
[Key words] Thyroidectomy
Recurrent laryngeal nerve
Electromyography
Lateral cricoarytenoid muscle
Intraoperative nerve monitoring
Issue Date2012
Publisher中华普通外科杂志
Citation中华普通外科杂志.2012,27,(4),272-275.
Abstract目的 探讨经环甲肌置入双极电极监测环杓侧肌复合肌肉动作电位以指导术中探查解剖显露喉返神经并评估其功能的有效性、可行性.方法 临床病例分为神经监测组及对照组,通过针刺电极记录环杓侧肌复合肌肉动作电位,间断刺激暴露或未暴露的喉返神经,对颈丛麻醉下甲状腺手术中喉返神经功能进行监测,对照组则常规显露喉返神经.结果 监测组与非监测组在手术时间(125.54 ±42.23 min比107.30±39.36 min)、术后住院天数(5.14 ±1.44d比5.05 ±1.31 d)相比差异均无统计学意义(均P >0.05).32侧神经在暴露前利用监护仪描记出解剖走行,其中25侧继续解剖暴露神经,神经暴露后走行与未暴露前解剖走行完全一致,未暴露前RIN刺激阈值(2.23±0.57) mA,暴露后刺激阈值(0.44±0.20) mA,差异有统计学意义(P<0.01),未暴露前诱发EMG波幅(307.98±253.47) μV,暴露后诱发EMG波幅(234.36±142.18)μV,差异无统计学意义(P>0.05).结论 颈丛麻醉下监测环杓侧肌肌电图探查解剖暴露喉返神经、术中评估喉返神经功能是一项安全、有效、可行的方法.
Objective To investigate the effectiveness and feasibility of intraoperaive recurrent laryngeal nerve(RLN) monitoring via lateral cricoarytenoid muscle(LCA) compound muscle action potential (CMAP) monitoring by bipolar electrode implanting. Methods Seventy-four cases were evenly divided into nerve monitoring group and non-monitoring group,NIM-Response 2.0 was applied into monitoring group for intraoperative nerve monitoring.A bipolar electrode was inserted into LCA to record CMAP,stimulating electrode intermittently stimulated exposed or unexposed recurrent laryngeal nerve to monitor the RLN function during cervical operation under the block anaesthesia of cervical plexus. Results There were no statistically significant differences (P > 0.05 ) in postoperative hospitalization days (5.14 ± 1.44 days,5.05 ± 1.31 days),operation time ( 125.54 ±42.23 min,107.30 ± 39.36 min) between monitoring group and the control group.Thirty-two RLNs were mapped their anatomical course with the NIM-Response 2.0 assistance before exposure,and 25 RLNs were anatomically exposed.The stimulating threshold between unexposed RLN (2.23 ± 0.57 mA) and exposed RLN ( 0.44 ± 0.20 mA) were statistically different ( P < 0.01 ),but the evoked EMG amplitude(307.98 ± 253.47 μV,234.36 ± 142.18 μV) were not statistically different (P > 0.05 ).With the NIM-Response 2.0 assistance the course of the unexposed RLNs detected were consistent to the course of the RLNs when exposed completely. Conclusions It is a effective and feasible method to monitor the RLN function by recording the CMAP of lateral cricoarytenoid muscle(LCA) via bipolar electrode implanted into LCA under block anaesthesia of the cervical plexus.
URIhttp://hdl.handle.net/20.500.11897/134791
ISSN1007-631X
DOI10.3760/cma.j.issn.1007-631X.2012.04.004
Indexed中文核心期刊要目总览(PKU)
中国科技核心期刊(ISTIC)
中国科学引文数据库(CSCD)
Appears in Collections:人民医院

Web of Science®



Checked on Last Week

Scopus®



Checked on Current Time

百度学术™



Checked on Current Time

Google Scholar™





License: See PKU IR operational policies.