摘要
目的探讨地塞米松协同阿托伐他汀治疗慢性硬膜下血肿(CSDH)钻孔引流术后的临床疗效。方法选择80例CSDH患者,按随机数字表法分为阿托伐他汀(ATO)组与地塞米松协同阿托伐他汀(DXM+ATO)组。两组均采用钻孔引流的手术方式。ATO组方案:口服阿托伐他汀28天。DXM+ATO组方案:给予阿托伐他汀和地塞米松,疗程共28天。患者于术后当天开始药物治疗。随访期为84天。比较两组CSDH复发率、神经功能恢复情况(Markwalder's Grading Scale and Glasgow Coma Scale)及并发症发生率。结果DXM+ATO组血肿复发率低于ATO组,差异有统计学意义(P=0.040)。两组并发症发生率差异无统计学意义(P=0.692,P=0.745,P=0.305)。DXM+ATO组术后MGS评分明显低于ATO组,GCS评分明显高于ATO组,差异有统计学意义(P=0.043,P=0.039)。结论地塞米松协同阿托伐他汀应用于CSDH患者钻孔引流术后,可显著降低血肿复发率,改善患者神经功能及预后。
Objective To investigate the clinical effect of combining atorvastatin and dexamethasone in the treatment of chronic subdural hematoma(CSDH)after drilling and drainage.Methods Eighty patients with CSDH were selected and randomly divided into atorvastatin(ATO)group and dexamethasone and atorvastatin(DXM+ATO)group according to the random number table method.Both groups used the method of drilling and drainage.ATO group protocol:oral atorvastatin for 28 days.DXM+ATO group protocol:Atorvastatin and dexamethasone were given for 28 days.Patients started medication on the day after surgery.The follow-up period was 84 days.The rates of CSDH recurrence,neurological recovery(Markwalder’s Grading Scale and Glasgow Coma Scale),and complications were compared between the two groups.Results The hematoma recurrence rate was lower in the DXM+ATO group than that in the ATO group,and the difference was statistically significant(P=0.040).There was no significant difference in the incidence of complications between the two groups(P=0.692,P=0.745,P=0.305).The MGS score of the DXM+ATO group was significantly lower than that of the ATO group,and the GCS score was significantly higher than that of the ATO group.The differences were statistically significant(P=0.043,P=0.039).Conclusion Dexamethasone combined with atorvastatin after drilling and drainage in patients with CSDH can significantly reduce the recurrence rate of hematoma and improve neurological function and prognosis of patients..
作者
陈卫良
苏稳
陈瑞
朱祖建
李建荣
王冠军
CHEN Weiliang;SU Wen;CHEN Rui(Haining People 8s Hospital,Zhejiang 314400,China)
出处
《浙江创伤外科》
2021年第1期1-3,共3页
Zhejiang Journal of Traumatic Surgery
