摘要
目的:探索阿托伐他汀联合立体定向微创技术清除颅内血肿的疗效。方法:纳入符合标准的自发性脑出血患者98例。随机分为微创手术组75例,予以微创手术及常规药物治疗;联合治疗组23例,予以微创手术及常规药物治疗,同时于入院后24 h内开始予以阿托伐他汀钙片20 mg/d,治疗90 d。随访90 d。主要终点指标:90 d时mRS评分提示不良结局(>3分)的患者比例;次要终点指标:颅脑CT血肿体积的变化。结果:治疗后1周、2周及出院时,2组血肿体积差异无统计学意义(P>0.05);随访90 d,微创手术组不良结局患者比例显著高于联合治疗组(P<0.01);2组的并发症发生率差异无统计学差异(P>0.05)。结论:对于已选择立体定向微创技术清除颅内血肿的患者,联合阿托伐他汀治疗可改善90 d时的临床预后情况。
Objective:To explore whether atorvastatin can improve the clinical prognosis of patients with intracranial hematoma treated by stereotactic minimally invasive technique.Methods:In this study,we included98 patients that met our requirements and were diagnosed with spontaneous intracerebral hemorrhage.Patients were randomly divided into the minimally invasive surgery group(75 cases)and combined treatment group(23 cases).Patients in both groups were given minimally invasive surgery and conventional medication,and the combined treatment group was additionally given atorvastatin calcium tablets 20 mg starting within 24 h of admission for 90 days at a dose of 20 mg/d.Patients were followed for 90 days.The primary endpoint of follow-up was the proportion of patients with adverse outcomes at 90 d as indicated by a>3 Modified Rankin Scale(mRS)score.The secondary endpoint was the hematoma volume change in the computed tomography(CT)of the skull.Results:At 1 and 2 weeks after treatment and at patient discharge,the two groups showed no significant difference in hematoma volume(P>0.05).By the end of the 90-day follow-up,the proportion of patients with adverse outcomes in the minimally invasive surgery group was significantly higher than that in the combined treatment group(P<0.01).The two groups showed no significant difference in rates of complication(P>0.05).Conclusion:For patients who have elected for stereotactic minimally invasive techniques to remove intracranial hematomas,combined treatment with atorvastatin can improve the clinical prognosis at 90-day.
作者
孙一彤
王丽琨
任思颖
毛远红
宋安军
秦冠南
胡晓纯
李颖慧
李琦
伍国锋
SUN Yi-tong;WANG Li-kun;REN Si-ying;MAO Yuan-hong;SONG An-jun;QIN Guan-nan;HU Xiao-chun;LI Ying-hui;LI Qi;WU Guo-feng(Graduate School of Guizhou Medical University,Guizhou 550025,China;Department of Emergency,Affiliated Hospital of Guizhou Medical University,Guizhou 550025,China;Department of Neurology,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处
《神经损伤与功能重建》
2020年第12期714-717,721,共5页
Neural Injury and Functional Reconstruction
基金
国家自然科学基金(No.81971126/H0906)。
关键词
脑出血
立体定向微创技术
阿托伐他汀
改良Rankin量表评分
intracerebral hemorrhage
stereotactic minimally invasive technology
atorvastatin
modified Rankin scale score
