三种不同用药方式对慢性硬膜下血肿患者钻孔引流术后复发的影响  

Influence of Three Different Drug Therapies on the Postoperative Recurrences for Chronic Subdural Haematoma Patients Following the Trepanation and Drainage

作　　者：陈利涛 CHEN Litao(Surgical 3 Department,Guangdong Jiexi People's Hospital,Jieyang,Guangdong 515400)

机构地区：[1]广东省揭西县人民医院外三科,广东揭阳515400

出　　处：《智慧健康》2022年第11期137-139,143,共4页Smart Healthcare

基　　金：揭阳市科技计划,项目名称:三种不同用药方式对慢性硬膜下血肿患者钻孔引流术后复发的影响,项目编号:2019ws024。

摘　　要：目的 分析三种不同用药方式对于慢性硬膜下血肿(CSDH)患者钻孔引流手术后复发的影响。方法 选取2019年11月-2021年10月广东省揭西县人民医院收治的CSDH患者共75例为研究对象,依据随机数表法划分成A、B、C三组各25例,三组均行钻孔引流术,同时术后予以常规治疗,在此基础上A组予以阿托伐他汀和地塞米松,B组仅予以阿托伐他汀,C组仅予以地塞米松,比较三组总有效率、治疗前后格拉斯哥昏迷评分(GCS)、日常生活能力评分(ADL)、血肿复发率及不良反应情况。结果 A组总有效率高于B组及C组(P <0.05)。治疗后,A组GCS、ADL评分高于B组及C组(P <0.05)。A组复发率低于B组及C组(P <0.05)。三组治疗期间均未产生显著的不良反应,仅A组1例出现轻度的胃肠道反应,B组1例出现肝酶升高,均经调整或者停止使用药物后恢复到正常状态。结论 和单一阿托伐他汀或地塞米松治疗相比,联合阿托伐他汀及地塞米松能减少CSDH患者钻孔引流手术后复发,改善其神经功能和日常生活能力,疗效确切,值得采用。Objective To analyze the influence of three different drug therapies on the postoperative recurrences for chronic subdural haematoma(CSDH) patients following the trepanation and drainage. Methods 75 CSDH patients of undergoing the trepanation and drainage, and then routine treatment from November 2019 to October 2021 in our hospital were chosen as research subjects.According to random number table, patients were divided into group A, group B and group C, 25 cases in each group. Besides, group A took atorvastatin and dexamethasone;group B took atorvastatin;group C took dexamethasone. The total effective rate, Glasgow coma scale(GCS) and activity of daily living(ADL) scores, haematoma recurrence rates and adverse reactions were compared. Results Total effective rate in group A was higher than group B and group C(P < 0.05);GCS and ADL scores in group A were higher than group B and group C(P < 0.05);the recurrence rate in group A was lower than group B and group C(P <0.05). Three groups had no obvious adverse reactions;group A just had one mild gastrointestinal reaction case;group B had one elevated liver enzyme case;patients returned to normal after drug adjustment or withdrawal. Conclusion Combined with single drug therapy, the combination of atorvastatin and dexamethasone can reduce the postoperative recurrences, and improve the neurological function, activity of daily living and treatment effects. It is worthy of application.

关 键 词：慢性硬膜下血肿 钻孔引流术 地塞米松 阿托伐他汀 血肿复发率 

分 类 号：R651.15[医药卫生—外科学]