立体定向血肿抽吸术联合阿托伐他汀治疗自发性脑出血的疗效观察  

Therapeutic effect of stereotactic hematoma aspiration combined with atorvastatin in the treatment of spontaneous cerebral hemorrhage

作　　者：廖洪民[1] 王勇[1] 黄建军[1] 朱家伟[1] 郑远 LIAO Hongmin;WANG Yong;HUANG Jianjun;ZHU Jiawei;ZHENG Yuan(Department of Neurosurgery,Guizhou Aerospace Hospital,Zunyi 563003,China)

机构地区：[1]贵州航天医院神经外科,贵州遵义563003

出　　处：《中国实用神经疾病杂志》2019年第1期60-63,共4页Chinese Journal of Practical Nervous Diseases

基　　金：中国航天科工集团医疗卫生科研项目(编号:2017-LCYL-020)

摘　　要：目的观察立体定向血肿抽吸术联合阿托伐他汀治疗自发性脑出血患者的疗效。方法回顾分析2015-01—2018-03贵州航天医院收治的出血量30～40 mL基底节区出血患者60例,随机分为对照组和观察组各30例,对照组早期接受立体定向血肿抽吸术及常规内科治疗,观察组除接受相同手术及内科治疗外,早期口服或鼻饲阿托伐他汀治疗(20 mg/次,1次/d,持续28 d)。采用美国国立卫生研究院卒中量表(NIHSS)评定2组治疗后14 d和30 d的神经功能状态,采用改良Rankin分级量表(mRS)评估患者治疗后90 d预后情况;比较2组患者术后90 d神经功能恢复良好率。结果 2组患者治疗后14 d、30 d NIHSS评分及30 d内再出血发生率比较,差异均无统计学意义(P>0.05);治疗后90 d观察组mRS评分及恢复良好率均高于对照组,差异有统计学意义(P<0.05)。结论基底节区出血量30～40 mL的患者采用立体定向血肿抽吸术联合常规剂量阿托伐他汀治疗安全有效且有更好的远期效果。Objective To observe the effect of stereotactic hematoma aspiration combined with atorvastatin in patients with spontaneous cerebral hemorrhage.Methods Retrospective analysis of 60 patients with basal ganglia hemorrhage from 30 to 40 mL in our hospital from January 2015 to March 2018,randomly divided into control group and observation group,30 cases in each group.The control group received stereotactic hematoma aspiration in the early stage.For routine medical treatment,the observation group received oral or nasal atorvastatin(20 mg/time,once/d for 28 days)in addition to the same surgery and medical treatment.The National Institutes of Health Stroke Scale(NIHSS)was used to assess the neurological status of the two groups at 14 and 30 days after treatment,and the modified Rankin Rating Scale(mRS)was used to assess the prognosis of the patients at 90 days after treatment;the neurological function recovered well at 90 days after surgery.Results There was no significant difference in NIHSS score at 14 and 30 days after treatment and the incidence of rebleeding within 30 days after treatment between the two groups(P>0.05).The mRS scores and recovery rate of the observation group were higher than those of the control group at 90 days after treatment,and the difference was statistically significant(P<0.05).Conclusion Patients with blepharospasm 30-40 mL were treated with stereotactic hematoma aspiration combined with conventional doses of atorvastatin for safe and has a better long term effect.

关 键 词：脑出血 自发性 立体定向抽吸术 阿托伐他汀 再出血率 

分 类 号：R743.34[医药卫生—神经病学与精神病学]