慢性硬膜下血肿手术治疗中联合应用尿激酶、阿托伐他汀钙片、糖皮质激素的效果

Effect of Combined Application of Urokinase,Atorvastatin Calcium Tablets and Glucocorticoids in the Surgical Treatment of Chronic Subdural Hematoma

目的:探讨慢性硬膜下血肿手术治疗中联合应用尿激酶、阿托伐他汀钙片、糖皮质激素治疗的效果。方法:选取2020年1月—2023年1月清镇市第一人民医院收治的慢性硬膜下血肿患者80例为研究对象,根据随机数字表法分成对照组与观察组,各40例。对照组实施常规手术治疗,观察组在对照组基础上给予尿激酶、阿托伐他汀钙片联合地塞米松治疗。比较两组治疗效果、临床指标、并发症发生率及复发率、中国脑卒中患者神经功能缺损程度评分量表(CSS)评分、日常生活能力量表(ADL)评分、视觉模拟评分法(VAS)评分、血肿量。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P=0.002);观察组引流时间、住院时间短于对照组,术后积液量、术后积气量少于对照组,差异有统计学意义(P<0.001);观察组并发症发生率、复发率均低于对照组,差异有统计学意义(P<0.05),治疗后观察组CSS、VAS评分及血肿量均低于对照组,ADL评分高于对照组,差异有统计学意义(P<0.05)。结论:将CT定位后颅骨钻孔引流术联合尿激酶、阿托伐他汀钙片、糖皮质激素治疗应用于慢性硬膜下血肿患者中,可有效提高治疗效果,改善手术指标,提高患者神经功能恢复、自理能力,降低并发症发生率及复发率、痛感与血肿量。

Objective:To investigate the effect of urokinase,atorvastatin calcium tablets and glucocorticoid in the surgical treatment of chronic subdural hematoma.Methods:A total of eighty patients with chronic subdural hematoma treated in Qingzhen First People's Hospital from January 2020 to January 2023 were selected as the study objects,and were divided into control group and observation group according to random number table method,with forty cases in each group.The control group received conventional surgery,and the observation group received urokinase,atorvastatin calcium tablets combined with dexamethasone on the basis of control group.The therapeutic effect,clinical indicators,complication rate and recurrence rate,Chinese stroke patients'neurological impairment scale(CSS)score,daily living ability scale(ADL)score,visual analogue scale(VAS)score and hematoma volume were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P=0.002);the drainage time and hospitalization time in the observation group were shorter than those in the control group,and the amount of postoperative fluid accumulation and volume of postoperative volume were less than those in the control group,the difference was statistically significant(P<0.001);the complication rate and recurrence rate of observation group were lower than control group,the difference was statistically significant(P<0.05);after treatment,CSS,VAS score and hematoma volume in observation group were lower than control group,ADL score was higher than control group,the difference was statistically significant(P<0.05).Conclusion:The application of CT-oriented skull trephoration and drainage combined with urokinase,atorvastatin calcium tablets and glucocorticoid in the treatment of chronic subdural hematoma can effectively improve the treatment effect,improve the surgical indicators,improve the recovery of nerve function and self-care ability of patients,and reduce the incidence of complications and recurrence,pain sensation and the amount of hematoma.