醒脑静联合阿托伐他汀钙治疗慢性硬膜下血肿患者的临床疗效

Clinical Efficacy of Xingnaojing Combined with Atorvastatin Calcium in the Treatment of Chronic Subdural Hematoma

目的:观察醒脑静联合阿托伐他汀钙治疗老年慢性硬膜下血肿(CSDH)患者术后的临床疗效。方法:选取2016年7月-2017年12月在本院行钻孔外引流术的老年CSDH患者66例。按照随机数字表法分为联合组(给予醒脑静+阿托伐他汀钙治疗)、醒脑静组(给予醒脑静治疗)、阿托伐他汀钙组(给予阿托伐他汀钙治疗),各22例。比较三组给药前及给药7、14、30 d的颅内神经功能情况(NIHSS评分)、颅内出血量,以及给药前后的血清炎症因子情况(TNF-α、hs-CRP)。结果:给药期间,三组NIHSS评分均较给药前降低,其中联合组在给药期间NIHSS持续降低,且均低于醒脑静组和阿托伐他汀钙组,比较差异均有统计学意义(P<0.05),且给药30 d,阿托伐他汀钙组NIHSS评分低于醒脑静组(P<0.05);给药7、14 d,三组颅内出血量均较治疗前均明显持续降低(P<0.05),但三组间比较差异均无统计学意义(P>0.05),给药30 d,联合组颅内出血量均低于其他两组及给药前(P<0.05),但醒脑静组和阿托伐他汀钙组颅内出血量比较差异无统计学意义(P>0.05);给药后,三组TNF-α和hs-CRP水平均低于给药前,且联合组均低于醒脑静组和阿托伐他汀钙组,比较差异均有统计学意义(P<0.05),但醒脑静组和阿托伐他汀钙组TNF-α和hs-CRP水平比较差异均无统计学意义(P>0.05)。结论:对于老年CSDH患者在行钻孔外引流术后,采用醒脑静联合阿托伐他汀钙治疗能显著改善患者神经功能缺损评分,促进血肿吸收,并能显著减少体内的炎症因子,值得推广应用。

Objective:To observe the clinical effect of Xingnaojing combined with Atorvastatin Calcium on postoperative elderly patients with chronic subdural hematoma(CSDH).Method:A total of 66 elderly CSDH patients who underwent drilling drainage in our hospital from July 2016 to December 2017 were selected.According to the random number table method,they were divided into combined group(given Xingnaojing+Atorvastatin Calcium treatment),Xingnaojing group(Xingnaojing treatment),Atorvastatin Calcium group(Atorvastatin Calcium treatment),22 cases in each group.The intracranial nerve function(NIHSS score)and the amount of intracranial hemorrhage were compared before and after administration7,14 and 30 days,and serum inflammatory factors(TNF-α,hs-CRP)before and after administration in three groups were compared.Restult:During the administration period,the NIHSS scores of three groups were lower than those of before administration,and the NIHSS scores of combined group were lower than those of Xingnaojing group and Atorvastatin Calcium group,the differences were statistically significant(P<0.05),and administration 30 d,the NIHSS scores of Atorvastatin Calcium group was lower than that of Xingnaojing group(P<0.05).Administration 7 and 14 d,the amount of intracranial hemorrhage in three groups was significantly lower than those of before treatment(P<0.05),but the three groups were compared,the differences were not statistically significant(P>0.05),administration 30 d,the amount of intracranial hemorrhage in combined group were lower than those of the other two groups and before administration(P<0.05),but the amount of intracranial hemorrhage in Xingnaojing group and Atorvastatin Calcium group was compared,the difference was not statistically significant(P>0.05).After administration,the TNF-αand hs-CRP levels in three groups were lower than those of before administration,and the combined group were lower than those of Xingnaojing group and Atorvastatin Calcium group,the differences were statistically significant(P<0.05),but the levels of TNF-αand hs-CRP in Xingnaojing group and Atorvastatin Calcium group were compared,the differences were not statistically significant(P>0.05).Conclusion:For elderly patients with CSDH after drilling drainage,Xingnaojing combined with Atorvastatin Calcium treatment can significantly improve the neurological deficit score,promote the absorption of hematoma and significantly reduce the inflammatory factors in the body,which is worthy of promotion and application.