Xu Min, Chen Pin, Zhu Xun, Wang Cunzu, Shi Xueqiang, Yu Bo
Department of Neurosurgery, Kunshan Hospital of Traditional Chinese Medicine, Kunshan Affiliated Hospital of Nanjing University of Chinese Medicine, Kunshan, Jiangsu Province, China.
Department of Neurosurgery, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China.
World Neurosurg. 2016 Jul;91:23-8. doi: 10.1016/j.wneu.2016.03.067. Epub 2016 Mar 29.
To investigate effects of atorvastatin on conservative and surgical treatment of patients with chronic subdural hematoma.
A retrospective analysis was performed of 109 patients (including 3 outpatients) with chronic subdural hematoma at Northern Jiangsu People's Hospital from April 2014 to October 2015. Patients' gender, age, Glasgow Coma Scale score, symptoms, history of antiplatelet or anticoagulant use, hematoma location, volume of hematoma, operation methods, and application of atorvastatin and its duration were recorded. Prognostic indicators including changes in hematoma volume and neurologic status were extracted. Statistical methods were conducted to evaluate drug efficacy.
Seven conservative patients received atorvastatin for 1-6 months (range, 3.57 ± 1.72 months). The volume of hematomas was ± 4.49 mL to 11.40 ± 4.46 mL (P > 0.05) after 1 month's atorvastatin treatment. Hematomas disappeared after 6 months in all 7 patients. In surgical patients, gender (P = 0.797), age (P = 0.063), Glasgow Coma Scale score (P = 0.216), history of antiplatelet or anticoagulant (P = 0.350), volume of hematoma after admission (P = 0.896), location (P = 0.282), and operation methods (P = 0.832) were nonsignificantly associated with follow-up groups, but atorvastatin was significantly associated with follow-up results (P = 0.045).
Atorvastatin has preliminarily been proved to be safe and effective for chronic subdural hematomas in both conservative and surgical patients and can provide a drug treatment strategy for neurosurgeons.
探讨阿托伐他汀对慢性硬膜下血肿患者保守治疗及手术治疗的效果。
对2014年4月至2015年10月在苏北人民医院就诊的109例慢性硬膜下血肿患者（包括3例门诊患者）进行回顾性分析。记录患者的性别、年龄、格拉斯哥昏迷量表评分、症状、抗血小板或抗凝药物使用史、血肿位置、血肿体积、手术方式以及阿托伐他汀的应用情况及其持续时间。提取包括血肿体积和神经功能状态变化在内的预后指标。采用统计学方法评估药物疗效。
7例保守治疗患者接受阿托伐他汀治疗1 - 6个月（范围为3.57±1.72个月）。阿托伐他汀治疗1个月后，血肿体积从±4.49 mL变为11.40±4.46 mL（P>0.05）。所有7例患者在6个月后血肿均消失。在手术治疗患者中，性别（P = 0.797）、年龄（P = 0.063）、格拉斯哥昏迷量表评分（P = 0.216）、抗血小板或抗凝药物使用史（P = 0.350）、入院时血肿体积（P = 0.896）、位置（P = 0.282）和手术方式（P = 0.832）与随访组无显著相关性，但阿托伐他汀与随访结果显著相关（P = 0.045）。
阿托伐他汀已初步证明对慢性硬膜下血肿的保守治疗和手术治疗患者均安全有效，可为神经外科医生提供一种药物治疗策略。
