阿托伐他汀钙联合高压氧治疗重型颅脑损伤开颅术后硬膜下积液的临床效果

Clinical Efficacy of Atorvastatin Calcium Combined with Hyperbaric Oxygen in the Treatment of Subdural Effusion after Craniotomy for Severe Traumatic Brain Injury

目的:探讨阿托伐他汀钙联合高压氧治疗重型颅脑损伤(SBI)患者开颅术后硬膜下积液(SE)的临床效果。方法:选取2022年6月—2023年10月揭阳市人民医院神经外科收治的76例SBI开颅术后出现SE的患者作为研究对象,采用数据库随机分组法将其分为A组和B组,各38例。A组采用高压氧治疗,B组采用阿托伐他汀钙联合高压氧治疗。比较两组治疗有效率、并发症发生率、检验指标、美国国立卫生研究院卒中量表(NIHSS)评分、临床指标、健康调查简表(SF-36)评分。结果:B组治疗总有效率高于A组,差异有统计学意义(P<0.05),B组并发症发生率低于A组,但两组间比较,差异无统计学意义(P>0.05)。治疗后,两组超敏C反应蛋白(hs-CRP)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、总胆固醇(TC)均优于治疗前,且B组上述指标优于A组,差异有统计学意义(P<0.05)。治疗后,两组NIHSS评分均低于治疗前,且B组低于A组,差异有统计学意义(P<0.05)。治疗后,两组硬膜下积液量少于治疗前,且B组少于A组,差异有统计学意义(P<0.05);B组颅内压恢复正常时间、住院时间短于A组,住院费用少于A组,差异有统计学意义(P<0.05)。治疗后,两组SF-36各项评分高于治疗前,且B组均高于A组,差异有统计学意义(P<0.05)。结论:阿托伐他汀钙联合高压氧治疗SBI开颅术后SE患者的效果显著,能改善神经功能,促使积液快速吸收,缩短康复时间,降低治疗花费,提高生活质量,且安全性高。

Objective:To investigate the clinical effect of Atorvastatin Calcium combined with hyperbaric oxygen in the treatment of subdural effusion(SE)after craniotomy in patients with severe traumatic brain injury(SBI).Method:A total of 76 patients with SE after SBI craniotomy admitted to the Neurosurgery Department of Jieyang City People's Hospital from June 2022 to October 2023 were selected as the study objects,and they were divided into group A and group B by database randomization method,with 38 cases in each group.Group A was treated with hyperbaric oxygen,group B was treated with Atorvastatin Calcium combined with hyperbaric oxygen.Treatment effective rate,incidence of complication,test indicators,National Institutes of Health stroke scale(NIHSS)score,clinical indicators,and the MOS item short from health survey(SF-36)score were compared between the two groups.Result:The treatment total effective rate of group B was higher than that of group A,the difference was statistically significant(P<0.05),the complication rate of group B was lower than that of group A,but there was no statistically significant difference between the two groups(P>0.05).After treatment,hypersensitive C-reactive protein(hs-CRP),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),triacylglycerol(TG)and total cholesterol(TC)in both groups were better than those before treatment,and the above indexes in group B were better than those in group A,the differences were statistically significant(P<0.05).After treatment,NIHSS scores in both groups were lower than those before treatment,and that in group B was lower than that in group A,the differences were statistically significant(P<0.05).After treatment,the amount of subdural effusion in the two groups were less than those before treatment,and that in group B was less than that in group A,the differences were statistically significant(P<0.05).The time to return to normal intracranial pressure and hospital stay in group B were shorter than those in group A,and the hospitalization cost was less than that in group A,the differences were statistically significant(P<0.05).After treatment,SF-36 scores in both groups were higher than those before treatment,and those in group B were higher than those in group A,the differences were statistically significant(P<0.05).Conclusion:Atorvastatin Calcium combined with hyperbaric oxygen is effective in the treatment of SE patients after SBI craniotomy,which can improve nerve function,promote rapid fluid absorption,shorten rehabilitation time,reduce treatment cost,improve quality of life,and have high safety.