不同剂量阿托伐他汀辅助钻孔引流术治疗慢性硬膜下血肿的疗效及安全性

发布时间：2018-08-27 18:52

【摘要】：目的探讨不同剂量的阿托伐他汀辅助钻孔引流术治疗慢性硬膜下血肿(CSDH)的疗效及用药的安全性。方法选取106例CSDH患者作为研究对象,按照随机数字表法分为观察组58例,对照组48例,两组均给予钻孔引流术治疗,观察组在引流术基础上口服高剂量阿托伐他汀钙片40 mg,1次/d;对照组口服低剂量阿托伐他汀钙片20 mg,1次/d,两组均连续治疗3个月后,比较两组的临床总有效率、日常生活能力量表(ADL)评分以及神经功能缺损评分标准(CSS)评分、血清超敏C反应蛋白(hs-CRP)和白细胞介素(IL)-6水平、不良反应情况及复发率。结果治疗3个月后,观察组总有效率(89.7%)显著高于对照组(72.9%)(P0.05)。治疗前两组ADL、CSS评分无统计学差异(P0.05);治疗后1个月、3个月,两组ADL评分均显著升高,且观察组显著高于对照组;两组CSS评分均显著降低,且观察组显著低于对照组(均P0.05)。治疗前两组血清hsCRP、IL-6水平比较无统计学意义(P0.05);治疗后1个月、3个月,两组血清hs-CRP、IL-6水平明显下降,且观察组下降幅度明显低于对照组(均P0.05)。两组不良反应发生率比较无统计学意义(P0.05),对照组复发率(14.6%)明显高于观察组(3.6%,P0.05)。结论高剂量阿托伐他汀辅助钻孔引流术能显著提高CSDH患者的临床疗效、改善日常生活能力及神经功能,复发率低且安全性良好。
[Abstract]:Objective to evaluate the efficacy and safety of Atto vastatin assisted drilling and drainage in the treatment of chronic subdural hematoma (CSDH). Methods 106 patients with CSDH were randomly divided into observation group (n = 58) and control group (n = 48). The observation group took high dose Atto vastatin calcium tablets for 40 mg,1 / d on the basis of drainage, while the control group took low dose Atto vastatin calcium tablets for 20 mg,1 / d. After 3 months of continuous treatment, the total clinical effective rate of the two groups was compared. The activity of daily living (ADL) scale (ADL), the neurological deficit score (CSS), the levels of serum high sensitive C-reactive protein (hs-CRP) and interleukin (IL) -6 (IL) -6), adverse reactions and recurrence rate were evaluated. Results after 3 months of treatment, the total effective rate in the observation group (89.7%) was significantly higher than that in the control group (72.9%) (P0.05). Before treatment, there was no significant difference in ADL,CSS score between the two groups (P0.05); after 1 month, 3 months after treatment, the ADL score of the two groups increased significantly, and the CSS score of the observation group was significantly higher than that of the control group; the CSS score of the two groups was significantly lower than that of the control group (P0.05). There was no significant difference in serum hsCRP,IL-6 levels between the two groups before treatment (P0.05); after one month and three months after treatment, the serum hs-CRP,IL-6 levels in the two groups decreased significantly, and the decrease in the observation group was significantly lower than that in the control group (P0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P0.05). The recurrence rate in the control group (14.6%) was significantly higher than that in the observation group (3.6%, P0.05). Conclusion High dose Atto vastatin assisted drilling and drainage can significantly improve the clinical efficacy of CSDH patients, improve the ability of daily living and nerve function, the recurrence rate is low and the safety is good.
【作者单位】：六盘水市人民医院神经外科;
【基金】：六盘水市科技计划项目(No.52020-2016-yh07)
【分类号】：R651.15

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