阿托伐他汀钙在治疗慢性硬膜下血肿的疗效分析

Analysis of the efficacy of atorvastatin calcium in the treatment of chronic subdural hematoma

目的探讨不同时期使用阿托伐他汀钙在慢性硬膜下血肿(chronic subdural hematoma,CSDH)钻孔引流术后的疗效。方法72例CSDH患者分为对照组(n=32)和研究组(n=40)。对照组于术后1周之后(平均12.52±2.53d)开始服用阿托伐他汀钙片,连服8周。研究组于术后1周内(平均1.42±0.84d)开始服用同剂量同周期的阿托伐他汀钙。比较两组术后1个月及3个月血肿量、神经功能、日常生活能力。结果术前血肿量对照组(73.53±17.64)ml、研究组(74.10±17.95)ml,差异无统计学意义(P>0.05)。术后1个月对照组及研究组血肿量分别为(29.62±4.20)ml、(22.52±3.96)ml,差异具有统计学意义(P<0.001)。术后3个月对照组及研究组血肿量分别为(13.09±2.24)ml、(11.87±2.48)ml,差异有统计学意义(P<0.05)。中国卒中量表(chinese stroke scale,CSS)评分,对照组术前(19.18±4.84)分,研究组术前(18.75±5.32)分,差异无统计学意义(P>0.05);术后1个月对照组及研究组CSS评分分别为(13.87±3.43)分、(9.87±3.26)分,差异有统计学意义(P<0.001);术后3个月对照组及研究组CSS评分分别为(6.65±2.65)分、(5.25±2.72)分,差异有统计学意义(P<0.05)。日常生活活动能力评分(activities of daily living scale,ADL)评分,术前对照组(54.06±16.51)分,研究组(56.87±14.74)分,差异无统计学意义(P>0.05),术后1个月ADL评分对照组及研究组分别为(67.96±11.27)分、(75.37±11.11)分,差异有统计学意义(P<0.05),术后3个月ADL评分对照组及研究组分别为(86.25±10.31)分、(90.37±8.27分),差异无统计学意义(P>0.05)。结论术后尽早使用阿托伐他汀钙片能促进CSDH患者近期血肿吸收、神经功能恢复及改善日常生活能力。

Objective To investigate the efficacy of atorvastatin calcium administered at different time points following drilling drainage surgery for chronic subdural hematoma(CSDH).Methods A total of 72 patients with CSDH were divided into a control group(n=32)and a study group(n=40).Patients in the control group began taking atorvastatin calcium tablets one week after surgery(average 12.52±2.53 days)and continued for 8 weeks.Patients in the study group started taking the same dose of atorvastatin calcium within one week after surgery(average 1.42±0.84 days)for the same duration.Hematoma volume,neurological function,and activities of daily living(ADL)were compared between the two groups at 1 and 3 months postoperatively.Results Preoperative hematoma volumes were similar between the control group(73.53±17.64 ml)and the study group(74.10±17.95 ml),with no statistically significant difference(P>0.05).At 1 month postoperatively,hematoma volumes were significantly lower in the study group(22.52±3.96 ml)compared to the control group(29.62±4.20 ml,P<0.001).At 3 months,hematoma volumes continued to be lower in the study group(11.87±2.48 ml)than in the control group(13.09±2.24 ml,P<0.05).Chinese Stroke Scale(CSS)scores were comparable preoperatively between the control group(19.18±4.84)and the study group(18.75±5.32,P>0.05).However,at 1 month postoperatively,CSS scores improved significantly in the study group(9.87±3.26)compared to the control group(13.87±3.43,P<0.001).This trend persisted at 3 months,with the study group scoring lower(5.25±2.72)than the control group(6.65±2.65,P<0.05).Preoperative ADL scores were similar between the two groups(control group:54.06±16.51;study group:56.87±14.74,P>0.05).At 1 month,ADL scores improved significantly in the study group(75.37±11.11)compared to the control group(67.96±11.27,P<0.05).However,at 3 months,the difference in ADL scores between the two groups was not statistically significant(control group:86.25±10.31;study group:90.37±8.27,P>0.05).Conclusions Early administration of atorvastatin calcium tablets after surgery can promote hematoma absorption,neurological recovery,and improve ADL in CSDH patients.