阿托伐他汀钙配合单孔双管冲洗引流治疗慢性硬膜下血肿疗效分析

目的 探讨阿托伐他汀钙配合单孔双管冲洗引流治疗慢性硬膜下血肿的临床疗效。方法 回顾分析2016年5月至2017年4月我院神经外科采用阿托伐他汀钙配合单孔双管冲洗引流治疗的42例慢性硬膜下血肿的临床预后及随访结果。男33例、女9例，年龄为38~82岁，平均年龄为（70.0±5.8）岁。42例患者均有头痛、头晕症状，36例有不同程度肢体肌力障碍。结果 42例患者中36例为单侧慢性硬膜下血肿，6例为双侧慢性硬膜下血肿。所有患者的头痛、头晕症状和肌力障碍术后24 h内均改善，1个月后症状完全消失。41例完全治愈，其中22例患者术后3个月时复查头颅计算机断层扫描（CT）提示血肿完全消失，19例患者术后6个月时复查头颅CT示血肿完全消失；1例（2.38%）双侧慢性硬膜下血肿患者因心房颤动口服华法林，术后1个月时复查头颅CT提示慢性硬膜下血肿复发，在随访过程中突发呼吸心跳骤停死亡。结论 阿托伐他汀钙配合单孔双管冲洗引流治疗慢性硬膜下血肿确实有效，值得推广应用。
Objective To explore the clinical efficacy of atorvastatin calcium combined with single-port double-tube irrigation and drainage in the treatment of chronic subdural hematoma. Methods The clinical prognosis and follow-up results of 42 patients with chronic subdural hematoma, who received treatment of atorvastatin calcium combined with single-hole double-tube irrigation and drainage in Department of Neurosurgery of our hospital from May 2016 to Apr. 2017, were retrospectively analyzed. There were 33 males and 9 females, aged 38-82 years with an average age of (70.0±5.8) years. Forty-two patients had headache and dizziness, and 36 patients had different severities of limb dysfunction. Results Of the 42 patients, 36 had unilateral chronic subdural hematoma and 6 had bilateral chronic subdural hematoma. The headache, dizziness and limb dysfunction were improved in all patients within 24 h after operation, and the symptoms completely disappeared after 1 month. Forty-one cases were completely cured, and cranial computed tomography (CT) examination showed that the hematoma completely disappeared at 3 months after operation in 22 cases and at 6 months after operation in 19 cases. One case (2.38%) with bilateral chronic subdural hematoma took warfarin orally due to atrial fibrillation. At 1 month after operation, the cranial CT examination showed a recurrence of chronic subdural hematoma, and the patient died of sudden cardiopulmonary arrest during follow-up. Conclusion Atorvastatin calcium combined with single-port double-tube irrigation and drainage is effective in the treatment of chronic subdural hematoma, and is worthy of popularization and application