钻孔尿激酶注入联合阿托伐他汀钙对慢性硬膜下血肿患者术后神经功能及预后的临床观察
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摘要
目的观察钻孔尿激酶注入联合阿托伐他汀钙对慢性硬膜下血肿患者术后神经功能恢复的影响及对患者预后相关因子影响。方法选取2014年1月至2016年12月就诊的230例患者,根据随机的原则分为对照组和研究组,每组115例。对照组给予患者钻孔引流治疗,研究组给予患者钻孔尿激酶联合阿托伐他汀钙治疗,观察2组患者的术后神经功能状况及其预后因素中临床疗效、血肿清除率、血肿复发率及并发症的发生情况。结果治疗前2组患者的性别比、年龄、病程、神经功能状态、血肿程度经比较差异无统计学意义(P> 0. 05);治疗后2组患者的神经功能状况较治疗前比较,差异有统计学意义(P <0. 01);治疗后研究组患者的神经功能状态、临床疗效、血肿清除率、血肿复发率及并发症的发生情况均明显优于对照组,差异有统计学意义(P <0. 05)。结论钻孔尿激酶注入联合阿托伐他汀钙治疗慢性硬膜下血肿患者术后神经功能恢复及其预后因素中临床疗效、血肿清除率、血肿复发率及并发症的发生情况影响意义重大,为个人、家庭及社会的健康可持续发展助力,值得临床进一步推广应用。
Objective To observe the effects of drilling urokinase injection combined with atorvastatin calcium on nerve function in postoperative patients with chronic subdural hematoma and prognosis. Methods A total of 230 patients,who were treated in our hospital from January 2014 to December 2016,were randomly divided into control group( n = 115)and research group( n = 115). The patients in control group were treated by trepanation & drainage. And the patients in reseach group were treated by drilling & urokinase combined with atorvastatin calcium. The neurological functional status after surgery,clinical effect,hematoma clearance rate,recurrence rate and incidence of complications were observed and compared between the two groups. Results Before treatment,there were no significant differences in patient 's sex and age,disease course,neurological functional status and hematoma degree between the two groups( P > 0. 05). After treatment,the neurological functional status,clinical effect,hematoma clearance rate,recurrence rate and incidence of complications of the patients in research group were supior to those in control group( P < 0. 05). Moreover,there was significant difference in the neurological functional status of the patients before and after treatment( P < 0. 01). Conclusion Drilling urokinase injection combined with atorvastatin calcium is very effective in treating the postoperative patients with chronic subdural hematoma,which can significantly improve the neurological functional status of the patients,with better clinical effect,higher hematoma clearance rate,lower recurrence rate and incidence of complications. Thus,it is worthy of clinical promotion.
Objective To observe the effects of drilling urokinase injection combined with atorvastatin calcium on nerve function in postoperative patients with chronic subdural hematoma and prognosis. Methods A total of 230 patients,who were treated in our hospital from January 2014 to December 2016,were randomly divided into control group( n = 115)and research group( n = 115). The patients in control group were treated by trepanation & drainage. And the patients in reseach group were treated by drilling & urokinase combined with atorvastatin calcium. The neurological functional status after surgery,clinical effect,hematoma clearance rate,recurrence rate and incidence of complications were observed and compared between the two groups. Results Before treatment,there were no significant differences in patient 's sex and age,disease course,neurological functional status and hematoma degree between the two groups( P > 0. 05). After treatment,the neurological functional status,clinical effect,hematoma clearance rate,recurrence rate and incidence of complications of the patients in research group were supior to those in control group( P < 0. 05). Moreover,there was significant difference in the neurological functional status of the patients before and after treatment( P < 0. 01). Conclusion Drilling urokinase injection combined with atorvastatin calcium is very effective in treating the postoperative patients with chronic subdural hematoma,which can significantly improve the neurological functional status of the patients,with better clinical effect,higher hematoma clearance rate,lower recurrence rate and incidence of complications. Thus,it is worthy of clinical promotion.
引文
1张超,刘小印,王传宝,等.皮质视觉等级量表进和脑萎缩指数对老年慢性硬膜下血肿的预测价值.中华老年心脑血管病杂志,2018,20:282-285.
2 李健,潘国栋.改良钻孔引流术治疗中老年慢性硬膜下血肿的临床体会.中国医药指南,2018,16:50-51.
3 杜文宇,杜玺生,萨日娜,等.硬膜下血肿血量计算方法.应用医学影像杂志,2018,19:65-66.
4 姚鹏飞,石鹏飞,荔志云.慢性硬膜下血肿发病机制及治疗研究的进展.临床神经外科杂志,2017,22:478-480.
5 李新才,孙兆良,姜秀峰,等.慢性硬膜下血肿发病机制及临床治疗的研究进展.中国微侵袭神经外科杂志,2017,22:281-283.
6 王黎云,李谷.钻孔引流及微创穿系数治疗混杂密度慢性硬膜下血肿的疗效对比.浙江创伤外科,2018,23:114-116.
7 刘海巍,陶胜忠,陈辉,等.慢性硬膜下血肿钻孔引流术术后复发的危险因素分析.重庆医学,2018,47:528-530.
8 张蕾,侯梅英,程刚,等.钻孔尿激酶注入引流联合阿托伐他汀钙治疗慢性硬膜下血肿的临床研究.中国现代手术学杂志,2017,21:398-400.
9 赵继宗主编.神经外科学.第1版.北京:人民卫生出版社,2007. 129-131.
10 刘刚,魏平波,何俊.氨甲环酸保守治疗混杂密度慢性硬膜下血肿的临床观察.国际神经病学神经外科学杂志,2017,44:527-530.
11 TanweerO,Frisoli FA,Bravate C. et al. Tranexamic Acid for treatment of Residual Subdural Hematoma After Twistdrill Evacuation Word Neurosurg,2016,3:29-33.
12 刘杜强,李定君.慢性硬膜下血肿的发病机制及药物治疗进展.现代医药卫生,2016,32:237-239.
13 张占英.外伤性慢性硬膜下血肿演变及治疗.中外医学研究,2017,16:154-156.
14 郑金平,赵子龙,江荣才.慢性硬膜下血肿的发病机制及他汀类药物在其应用的研究进展.广东医学,2017,38:155-157.
15 李铎.慢性硬膜下血肿钻孔引流术后联合高压氧治疗的临床疗效.航空航天医学杂志,2018,29:19-21.
16 曲月波,温吉海,韩邦涛,等.尿激酶辅助引流治疗慢性硬膜下血肿的疗效观察.临床医药文献电子杂志,2017,64:12631.
17 景慎东,胡延霞,李宪峰.尿激酶在微创手术治疗慢性硬膜下血肿中的作用.中国临床神经外科杂志,2016,11:707-709.
18 谢琳,李凯舒,田立美,等.口服阿托伐他汀钙片联合钻孔引流术治疗慢性硬膜下血肿的疗效分析.岭南现代临床外科,2017,17:721-724.
19 杨开华,余云湖,冉启山,等.阿托伐他汀钙片治疗非创伤性硬膜下血肿的临床研究.中国临床药理学杂志,2017,18:1751-1753.
20 航立航,黄柒金,蔡志强.醒脑静联合阿托伐他汀钙治疗慢性硬膜下血肿的疗效观察.中国微侵袭神经外科杂志,2017,12:548-550.
21 李学,王增光.舒血宁注射液联合阿托伐他汀钙治疗来年慢性硬膜下血肿的临床研究.现代药物与临床,2017,32:1433-1436.
22 唐斌,王本瀚,李经纶,等.关于脑外伤所致硬膜下血肿的手术治疗分析.中国医药指南,2017,14:133.
23 徐长松.微创钻颅治疗慢性硬膜下血肿的疗效研究.南京中医药大学,2017.
2 李健,潘国栋.改良钻孔引流术治疗中老年慢性硬膜下血肿的临床体会.中国医药指南,2018,16:50-51.
3 杜文宇,杜玺生,萨日娜,等.硬膜下血肿血量计算方法.应用医学影像杂志,2018,19:65-66.
4 姚鹏飞,石鹏飞,荔志云.慢性硬膜下血肿发病机制及治疗研究的进展.临床神经外科杂志,2017,22:478-480.
5 李新才,孙兆良,姜秀峰,等.慢性硬膜下血肿发病机制及临床治疗的研究进展.中国微侵袭神经外科杂志,2017,22:281-283.
6 王黎云,李谷.钻孔引流及微创穿系数治疗混杂密度慢性硬膜下血肿的疗效对比.浙江创伤外科,2018,23:114-116.
7 刘海巍,陶胜忠,陈辉,等.慢性硬膜下血肿钻孔引流术术后复发的危险因素分析.重庆医学,2018,47:528-530.
8 张蕾,侯梅英,程刚,等.钻孔尿激酶注入引流联合阿托伐他汀钙治疗慢性硬膜下血肿的临床研究.中国现代手术学杂志,2017,21:398-400.
9 赵继宗主编.神经外科学.第1版.北京:人民卫生出版社,2007. 129-131.
10 刘刚,魏平波,何俊.氨甲环酸保守治疗混杂密度慢性硬膜下血肿的临床观察.国际神经病学神经外科学杂志,2017,44:527-530.
11 TanweerO,Frisoli FA,Bravate C. et al. Tranexamic Acid for treatment of Residual Subdural Hematoma After Twistdrill Evacuation Word Neurosurg,2016,3:29-33.
12 刘杜强,李定君.慢性硬膜下血肿的发病机制及药物治疗进展.现代医药卫生,2016,32:237-239.
13 张占英.外伤性慢性硬膜下血肿演变及治疗.中外医学研究,2017,16:154-156.
14 郑金平,赵子龙,江荣才.慢性硬膜下血肿的发病机制及他汀类药物在其应用的研究进展.广东医学,2017,38:155-157.
15 李铎.慢性硬膜下血肿钻孔引流术后联合高压氧治疗的临床疗效.航空航天医学杂志,2018,29:19-21.
16 曲月波,温吉海,韩邦涛,等.尿激酶辅助引流治疗慢性硬膜下血肿的疗效观察.临床医药文献电子杂志,2017,64:12631.
17 景慎东,胡延霞,李宪峰.尿激酶在微创手术治疗慢性硬膜下血肿中的作用.中国临床神经外科杂志,2016,11:707-709.
18 谢琳,李凯舒,田立美,等.口服阿托伐他汀钙片联合钻孔引流术治疗慢性硬膜下血肿的疗效分析.岭南现代临床外科,2017,17:721-724.
19 杨开华,余云湖,冉启山,等.阿托伐他汀钙片治疗非创伤性硬膜下血肿的临床研究.中国临床药理学杂志,2017,18:1751-1753.
20 航立航,黄柒金,蔡志强.醒脑静联合阿托伐他汀钙治疗慢性硬膜下血肿的疗效观察.中国微侵袭神经外科杂志,2017,12:548-550.
21 李学,王增光.舒血宁注射液联合阿托伐他汀钙治疗来年慢性硬膜下血肿的临床研究.现代药物与临床,2017,32:1433-1436.
22 唐斌,王本瀚,李经纶,等.关于脑外伤所致硬膜下血肿的手术治疗分析.中国医药指南,2017,14:133.
23 徐长松.微创钻颅治疗慢性硬膜下血肿的疗效研究.南京中医药大学,2017.