口服阿托伐他汀钙片联合钻孔引流术治疗慢性硬膜下血肿的疗效分析

Efficacy of oral atorvastatin calcium combined with drilling drainage in the treatment of chronic subdural hematoma

目的比较口服阿托伐他汀钙片联合钻孔引流术与单纯钻孔引流术治疗慢性硬膜下血肿(CSDH)的疗效。方法收集中山大学孙逸仙纪念医院与广东同江医院2016年1月至2017年7月期间行钻孔引流术治疗的慢性硬膜下血肿患者资料,以是否辅助口服阿托伐他汀钙片将患者分为观察组36例与对照组32例。观察组行钻孔引流术后辅以口服阿托伐他汀钙片8~12周,对照组单纯行钻孔引流术,然后对比两组间治疗效果,以及术后第8周Karnofsky(KPS)功能状态评分差异。结果观察组总有效率(97.22%)与对照组(84.38%)差异无统计学意义(χ~2=2.062,P=0.151),而观察组治疗效果则优于对照组(Z=-2.413,P=0.016)。观察组复发率(0%)低于对照组(12.5%),差异有统计学意义(χ~2=4.711,P=0.03)。术后第8周KPS评分,观察组平均评分(92.78±9.74)高于对照组(87.19±12.50),差异有统计学意义(Z=-2.093,P=0.036)。结论口服阿托伐他汀钙片联合钻孔引流术治疗慢性硬膜下血肿效果优于单纯钻孔引流术,且血肿复发率低,更有助于患者术后神经功能恢复。

Objective To compare the efficacy of oral atorvastatin calcium combined with drilling and drainage with simple drilling drainage in the treatment of chronic subdural hematoma(CSDH).Methods The data of patients with chronic subdural hematoma treated by drilling and drainage were collected from Sun Yat-sen Memorial Hospital of Sun Yat-sen University and Guangdong Tongjiang Hospital from January 2016 to July 2017. Patients were divided into observation group(36 cases)and control group(32 cases)according to whether they aided oral administration of atorvastatin calcium tablets.In the observation group,the patients were treated with oral atorvastatin calcium for more than 8 weeks after drilling and drainage,while the control group received drilling and drainage only. The treatment effect and Karnofsky(KPS)functional score were compared between the two groups. Results The total effective rate(97.22%)in the observation group was not significantly different from that in the control group(84.38%)(χ~2=2.062,P=0.151). However,the therapeutic efficacy of observation group was better than that of the control group(Z=-2.413,P=0.016). The recurrence rate in the observation group(0%)was lower than that in the observation group(12.5%)(χ~2=4.711,P=0.03). The KPS score at the 8 th week after surgery was significantly higher in the observation group(92.78±9.74)than in the control group(87.19±12.50),with a significant difference(Z=-2.093,P=0.036). Conclusion Atorvastatin combined with drilling and drainage shows better therapeutic efficacy and lower recurrence rate,also helps patients in neurological recovery.