钻孔引流术联合阿托伐他汀钙治疗慢性硬膜下血肿的临床疗效及其对神经功能的影响

Efficacy of drilling and drainage combined with atorvastatin calcium in the treatment of chronic subdural hematoma and its impact on neurological function of patients

目的 观察钻孔引流术后联合阿托伐他汀钙治疗慢性硬膜下血肿的临床疗效及其对神经功能的影响。方法 选取2018-2020年三明市沙县区总医院收治的慢性硬膜下血肿患者62例,采用双盲法分为常规组和研究组,各31例。常规组在钻孔引流术后联用常规药物,研究组在钻孔引流术后联用阿托伐他汀钙,2组均连续用药2个月。比较2组临床疗效,治疗前后中国脑卒中临床神经功能缺损程度评分量表(CSS)评分、日常生活活动能力(ADL)评分、实验室指标[肿瘤坏死因子α(TNF-α)、神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)],并发症发生情况。结果 研究组总有效率为96.77%,高于常规组的80.65%(χ^(2)=4.026,P=0.045)。治疗后,2组CSS评分低于治疗前,ADL评分高于治疗前,且研究组CSS评分低于常规组,ADL评分高于常规组(P<0.01)。治疗后,2组血清TNF-α、NSE、BDNF水平低于治疗前,且研究组低于常规组(P<0.01)。研究组并发症总发生率为6.45%,低于常规组的32.26%(χ^(2)=6.613,P=0.010)。结论 钻孔引流术后联合阿托伐他汀钙治疗慢性硬膜下血肿的临床疗效确切,能有效减轻神经功能损伤,改善神经功能,减轻炎性反应,提高日常生活活动能力,且安全性较高。

Objective To investigate the efficacy of drilling and drainage combined with atorvastatin calcium in the treatment of chronic subdural hematoma and its impact on neurological function of patients.Methods A total of 62 patients with chronic subdural hematoma received in Shaxian District General Hospital from 2018 to 2020 were selected as the research objects,and they were divided into the conventional group and study group by double-blind method,31 cases in each group.All patients were treated by drilling and drainage,patients in conventional group were given conventional medicine after operation,and patients in study group were given atorvastatin calcium after operation,both groups were treated for 2 months.Clinical efficacy,scores of CSS,ADL,laboratory indexes(TNF-α,NSE,BDNF) before and after treatment,incidence of complications were compared between the two groups.Results After treatment,the total effective rate of the study group was96.77%,was higher than 80.65%of the conventional group(χ^(2)=4.026,P=0.045).After treatment,CSS score in the two groups was lower than that before treatment,ADL score was higher than that before treatment,and CSS score in the study group was lower than that of the conventional group,ADL score was higher than that of the conventional group(P<0.01).After treatment,levels of TNF-α,NSE and BDNF in the two groups were lower than those before treatment,and the study group were lower than those in the conventional group(P<0.01).Incidence of complications in the study group was 6.45%,lower than 32.26%in the conventional group(χ^(2)=6.613,P=0.010).Conclusion Drilling drainage combined with atorvastatin calcium have an exact clinical effect in the treatment of chronic subdural hematoma,and can effectively reduce neurological damage,improve neurological function,promote their ability of daily living,and with high safety.