尿激酶加阿托伐他汀钙联合手术治疗慢性硬膜下血肿的临床效果

Clinical effect of urokinase plus atorvastatin calcium combined with surgery in the treatment of chronic subdural hematoma

目的观察尿激酶加阿托伐他汀钙联合手术治疗慢性硬膜下血肿的临床效果。方法选取2018年7月-2019年6月云南省滇南中心医院/红河州第一人民医院收治的慢性硬膜下血肿患者70例,选用双盲法随机分为试验组和常规组各35例。常规组患者行手术治疗,试验组患者行尿激酶加阿托伐他汀钙联合手术治疗。比较2组患者血肿控制率、治疗前后神经功能缺损评分、认知功能评分、日常生活能力评分、并发症发生情况、血肿复发情况及症状消失时间、住院时间、住院费用。结果试验组的血肿控制率为97.14%,明显高于常规组的74.29%(χ^(2)=7.467,P=0.006)。治疗后,2组神经功能缺损评分、认知功能评分及日常生活能力评分均优于治疗前,且试验组显著优于常规组(P<0.01)。试验组的并发症总发生率为2.86%,低于常规组的20.00%(χ^(2)=5.081,P=0.024)。试验组的血肿复发率为0,低于常规组的17.14%(6/35)(χ^(2)=6.562,P=0.010)。试验组的症状消失时间及住院时间均短于常规组,住院费用低于常规组(P<0.01)。结论尿激酶加阿托伐他汀钙联合手术治疗慢性硬膜下血肿效果显著,可改善患者的神经功能缺损、认知功能及日常生活能力,并发症少,复发少,值得广泛应用。

Objective To observe the clinical effect of urokinase plus atorvastatin calcium combined with surgery in the treatment of chronic subdural hematoma.Methods A total of 70 patients with chronic subdural hematoma who were admitted to Southern Central Hospital of Yunnan Province/the First People's Hospital of Honghe State from July 2018 to June 2019 were selected,and they were randomly divided into experimental group(35 cases)and conventional group(35 cases)by double-blind method.The conventional group received surgical treatment,and the experimental group received urokinase plus atorvastatin calcium combined surgical treatment.The hematoma control rate,neurological deficit score before and after treatment,cognitive function score,ability of daily living score,complications,hematoma recurrence and symptom disappearance time,hospitalization time,and hospitalization expenses were compared between the two groups.Results The control rate of hematoma in the experimental group(97.14%)was significantly higher than that in the conventional group(74.29%)(χ^(2)=7.467,P=0.006).After treatment,the scores of neurological deficit,cognitive function and ability of daily living in the two groups were better than those before treatment,and the experimental group was significantly better than the conventional group(P<0.01).The total incidence of complications in the experimental group(2.86%)was lower than that in the conventional group(20.00%)(χ^(2)=5.081,P=0.024).The recurrence rate of hematoma in the experimental group(0)was lower than that in the conventional group(17.14%,6/35)(χ^(2)=6.562,P=0.010).The symptom disappearance time and hospitalization time of the experimental group were shorter than those of the conventional group,and the hospitalization cost was lower than that of the conventional group(P<0.01).Conclusion Urokinase plus atorvastatin calcium combined surgery is effective in the treatment of chronic subdural hematoma,which can improve the patient's neurological deficit,cognitive function and ability of daily living,with fewer complications and less recurrence,it is worthy of wide application.