钻孔引流术联合阿托伐他汀治疗慢性硬膜下血肿的疗程研究

Observation on the treatment course of minimally invasive burr hole drainage procedure plus atorvastatin in chronic subdural hematoma

目的:探讨微创钻孔引流术联合阿托伐他汀治疗慢性硬膜下血肿(CSDH)的最优疗程。方法:回顾性分析六安市人民医院神经外科72例微创钻孔引流术后联合应用阿托伐他汀治疗CSDH患者的临床资料,按照阿托伐他汀用药疗程的不同分为短期组(1个月)、中期组(2个月)和长期组(3个月)。比较分析3组患者治疗结束后的治疗有效率、美国国立卫生研究院卒中量表(NIHSS)及日常生活活动能力量表(ADL)评分、术后并发症发生率及复发率情况。结果:治疗有效率短期组(69.23%)、中期组(92.31%)、长期组(95.00%)呈逐渐上升趋势(P<0.05);治疗结束时,中期组和长期组的NIHSS评分低于短期组,ADL评分高于短期组(P<0.05);长期组术后总体并发症发生率为35.00%,中期组为61.54%,短期组为73.08%,中、长期组低于短期组(P<0.05);复发率方面,短期组(38.46%)、中期组(15.38%)、长期组(10.00%)呈逐渐降低趋势(P<0.05)。结论:钻孔引流术联合阿托伐他汀治疗CSDH,用药3个月为最优疗程。

Objective:To observe the optimal treatment course of minimally invasive burr hole drainage procedure combined with atorvastatin in chronic subdural hematoma(CSDH).Methods:The clinical data were retrospectively analyzed in 72 cases of CSDH undergone minimally invasive burr hole drainage procedure plus atorvastatin in our department.By medication course of atorvastatin, the cases were divided into short-term group(1 month),mid-term group(2 months) and long-term group(3 months).Then the three groups were analyzed and compared regarding the effective rate, scoring on National Institute of Health Stroke Scale(NIHSS) and activities of daily living(ADL),rates of postoperative complications and recurrence after the course of medication.Results:The effective rate tended to increase in short-term(69.23%),mid-term(92.31%) and long-term groups(95.00%)(all P<0.05).Scoring on NIHSS was significantly lower in the mid-and long-term groups than in short-term group(P<0.05),yet ADL score in the mid-and long-term groups was markedly higher than that in the short-term group(P<0.05) at the end of therapy.The overall incidence of postoperative complications was 35.00%,61.54% and 73.08%,respectively for the long-term group, mid-term group and short-term group, with notably lower postoperative complications in the long-term group than in short-term group(P<0.05).The recurrence rate tended to decrease from short-term group to long-term group(38.46%,15.38% and 10.00%,all P<0.05).Conclusion:Three months may be the best course of treatment for CSDH patients treated with minimally invasive burr hole drainage procedure combined with atorvastatin.