阿托伐他汀联合钻孔引流术治疗慢性硬膜下血肿伴凝血功能障碍的效果观察  

Observation of atorvastatin in combination with trepanation and drainage in treatment of chronic subdural hematoma with blood coagulation dysfunction

作　　者：王建涛[1] 施立海[1] 阚志生[1] 

机构地区：[1]首都医科大学附属北京安贞医院神经外科,100029

出　　处：《中国医药》2017年第3期365-369,共5页China Medicine

摘　　要：目的比较阿托伐他汀联合钻孔引流术与常规钻孔引流术治疗慢性硬膜下血肿伴凝血功能障碍的效果。方法回顾性分析2010年1月至2016年6月首都医科大学附属北京安贞医院神经外科手术治疗的186例伴凝血功能障碍慢性硬膜下血肿患者的临床资料，根据是否服用他汀类药物分为观察组（90例）和对照组（96例）。观察组给予阿托伐他汀联合钻孔引流术治疗；对照组给予传统钻孔引流治疗。比较2组治疗效果和复发率。结果观察组与对照组治疗总有效率比较[94．4％（85／90）比92．7％（89／96）]，差异无统计学意义（x^2=0．033，P〉0．05）。观察组复发3例（3．3％），对照组复发12例（12．5％），观察组复发率明显低于对照组，差异有统计学意义（x^2=4．101，P〈0．05）。结论阿托伐他汀联合钻孔引流术治疗慢性硬膜下血肿伴凝血功能障碍效果较单用钻孔引流术好，且血肿复发率低。Objective To observe the curative effect of atorvastatin in combination with trepanation and drainage on chronic subdural hematoma（CSDH） with blood coagulation dysfunction. Methods A total of 186 cases of CSDH with blood coagulation dysfunction from January 2010 to June 2016 in Beijing Anzhen Hospital, Capital Medical University were retrospectively analyzed. The patients were divided into 2 groups; the control group （n =96） had conventional surgical treatment of trepanation and drainage ; the observation group （ n = 90） had trepanation and drainage combined with atorvastatin. Clinical effect and hematoma relapse rate were analyzed. Results The total effective rate had no significant difference between observation group and control group [ 94. 4% （85/90） vs 92. 7% （89/96） ] （x^2 = 0. 033, P 〉 0. 05 ）. There were 3 cases （3.3%） of relapse in observation group and 12 cases （12.5%） of relapse in control group; the relapse rate in observation group was significantly lower than that in control group （x^2 = 4. 101, P 〈0. 05 ）. Conclusion Trepanation and drainage in combination with atorvastatin treating CSDH with blood coagulation dysfunction can improve clinical effect and reduce hematoma relapse.

关 键 词：血肿 硬膜下 慢性 钻孔引流术 阿托伐他汀 术后复发 

分 类 号：R651.1[医药卫生—外科学]