阿托伐他汀治疗单纯型亚急性硬膜下血肿疗效观察

The study on the therapeutic effect of atorvastatin in treatment of simple subacute subdural hematoma

目的探讨阿托伐他汀治疗单纯型亚急性硬膜下血肿(subacute subdural hematoma,SASDH)的疗效。方法选择2015年1月至2020年1月采取保守治疗的64例单纯型亚急性硬膜下血肿患者,采取营养神经等常规治疗(对照组,28例),在此基础上部分患者予阿托伐他汀钙治疗(阿托伐他汀组,36例),评价两组患者治疗情况、并发症发生率及复发率、住院总时间与治疗总费用、CT疗效及Glasgow预后分级。结果阿托伐他汀组31例血肿量无增加,5例血肿量稍有增加,且经阿托伐他汀治疗,全部血肿吸收;而对照组21例血肿量增加,且均转为手术治疗,血肿量增加与转为手术比较两组均有统计学差异(P<0.05)。两组在肝肾功能异常、感染等并发症及复发率比较均无统计学差异(P>0.05),但阿托伐他汀组癫痫的发生(3例)低于对照组(10例),差异有统计学意义(P<0.05)。对照组住院时间(18.61±6.84)d明显长于阿托伐他汀组(11.08±4.56)d,差异有统计学意义(P<0.05)。由于住院时间长,对照组的治疗总费用(1.34±0.61)万元高于阿托伐他汀组(0.58±0.41)万元,差异有统计学意义(P<0.05)。随访两组疗效及残疾率比较,差异均无统计学意义(P>0.05)。结论阿托伐他汀治疗单纯型亚急性硬膜下血肿具有促进血肿吸收,减少癫痫发生等优点,由于减少了手术操作,缩短了住院时间及降低了住院总费用,从而减轻了患者的痛苦及经济负担。

Objective To explore the effects of atorvastatin in the treatment of simple subacute subdural hematoma(SASDH). Methods Sixty-four subacute subdural hematoma patients who underwent conservative treatment from January 2015 to January 2020 were included in the study. Patients were assigned to either control group who received conventional treatment such as nerves nutrients(28 cases) or atorvastatin group who received atorvastatin calcium(36 cases). The incidence of complications and recurrence rates, the total length of hospitalization and total treatment costs, CT efficacy and Glasgow outcome scale(GOS)were compared between the two groups. Results In the atorvastatin group, 31 patients had no increase in the hematoma and 5 patients had a slight increase in the hematoma. all hematomas were absorbed after atorvastatin treatment. In the control group, 21 cases had an increase in the hematoma which were all converted to surgical treatment. There was significant differences in the increase of hematoma and the conversion to the surgery between the two groups(P<0.05). There were no differences in liver and kidney dysfunctions,infections and recurrence rates between the two groups(P>0.05). However, the incidence of epilepsy in the atorvastatin group(3 cases) was significantly lower than that in the control group(10 cases)(P <0.05). The hospital stay was significantly longer in the control group than that of the atorvastatin group days(18.61 ±6.84 vs. 11.08±4.56 P<0.05).Due to the long hospital stay, the total treatment cost of the control group(1.34 ±0.61) per ten thousand yuan was significantly higher than that of the atorvastatin group(0.58±0.41) per ten thousand yuan(P<0.05). There were no significant differences in the CT efficacy and the disability rate between the two groups during follow-up(P >0.05). Conclusion Treatment with atorvastatin promotes the absorption of hematoma and reduces the occurrence of epilepsy in patients with simple subacute subdural hematoma. In addition, atorvastatin reduces the time of surgical operations, shortens the length of hospitalization and lowers the total cost of hospitalization, thereby reducing the pain and economic burden of patients.