中文摘要：

目的 比较不同神经损伤病程的单侧声带麻痹患者行颈袢喉返神经吻合术效果的差异，分析喉返神经损伤病程对该神经修复术效果的影响。方法分析自1996年1月至2013年1月在第二军医大学长海医院耳鼻咽喉头颈外科接受颈袢喉返神经修复术的467例单侧声带麻痹患者的病例资料。术前及术后采用动态喉镜、听感知评估、嗓音客观参数、最长发声时间及喉肌电图等参数及检查评价疗效，采用多因素回归分析方法对可能的疗效影响因素：患者年龄、性别、术前肌电图（神经损伤程度）及神经损伤病程进行多因素分析。在确认失神经病程为影响因素后，对其进一步行分层分析。结果多因素逻辑回归分析结果证实年龄、术前肌电图及失神经病程都是显著性变量。对失神经病程这一确定的显著性变量进一步行分层分析的结果显示，失神经病程6—12个月组（含12个月）及12—24个月（含24个月）组与大于24个月组之间的手术效果差异均有统计学意义（P〈0．05），而6—12个月组与12～24个月组之间手术效果差异无统计学意义（P〉0．05）。但是，所有失神经亚组术后各个评价指标相对术前值均有显著性改善，差异均有统计学意义（P〈0．01）。结论尽管对于单侧声带麻痹患者来说，延期喉返神经修复术也被证实是有效的，但是神经损伤后2年内行神经修复术的手术效果明显好于神经损伤病程大于2年的患者。

英文摘要：

Objective To study the effect of denervating duration on the surgical outcome of laryngeal reinnervation in patients with unilateral vocal fold paralysis （UVFP）. Methods The charts of 467 consecutive patients with UVFP were reviewed retrospectively. Preoperative and postoperative data, including videostroboscopy, perceptual evaluation of voice （ GRBAS scale）, acoustic analysis, maximum phonation time （MPT） and laryngeal reinnervation were collected. Multivariabie logistic regression analysis was used to identify possible influential factors including the age of patient, gender, degree of nerve injury and duration of nerve injury. Then stratification analysis was performed on the variable-duration of nerve injury, to study how the duration of nerve injury could affect the surgical outcome of laryngeal reinnervation. Results Muhivariable logistic regression analysis showed that the age of patient, degree of nerve injury and duration of nerve injury were significant variables. Stratification analysis on duration of nerve injury demonstrated that in each subgroup postoperative data were significantly improved. When compared among the three subgroups, postoperative data in group with a duration of 6 - 12 months and group with a duration 12 -24 months were significantly better than group with a duration more than 24 months. However, there were no significant differences between group with a duration of 6 - 12 months and 12 - 24 months. Conclusion Surgical outcome of laryngeal reinnervation is better in patients those with a duration of nerve injury less than 2 years than in those with a duration of nerve injury more than 2 years.