Observation Of The Effect Of Simvastatin On The Postoperative Residual Hematoma In Patients With Chronic Subdural Hematoma

Objective: To observe whether simvastatin can promote the absorption of postoperative residual hematoma in patients with chronic subdural hematoma, improve the functional status of the brain in the patients, and prevent the postoperative recurrence of chronic subdural hematoma.Methods: 40 patients with chronic subdural hematoma, who received the operation of burr hole drainage in the Second People’s Hospital of Chengdu, were collected from October 2014 to December 2015. They were divided into treatment group and control group by random grouping method. 2 days after operation, 20 cases as treatment group had been given oral simvastatin 20mg/day for 20 days, while the others, serving as control group, hadn’t been given simvastatin. They were regularly followed up for 3 months. They were received brain CT scan on the 2 days after operation, the first week, the fourth week, the eighth week, and twelfth week. Then, the hematoma volume was caculated by improved Coniglobus formula. Moreover, in those 5 periods, their Markwalder grading scores(MGS) were assessed. The recurrence was also recorded in 3 months after operation. Finally, the data were statistically analyzed via SPSS17.0 statistical software.Results: For the test group, the hematoma volumes of V1, V2, V3, V4 and V5 were 20.09±6.13, 19.93±5.96, 11.93±5.25, 8.54±5.92, 9.02±6.15. For the control group, V1, V2, V3, V4, and V5 were 19.45±5.82, 20.31±4.84, 24.08±6.16, 27.06±12.35, 26.85±13.18. The V1 and V2 between both groups were not statistically significant(P > 0.05), but the V3, V4 and V5 in the treatment group were less than those in the control group(P < 0.05). For the treatment group, MGS1 from 0-4 were 4,11,5,0,0, MGS2 5,10,5,0,0, MGS3 18,1,1,0,0, MGS4 17,2,0,0,0, MGS5 18,1,0,0,0; similarly, MGS1 in the control group from 0-4 were 3,11,6,0,0, MGS2 5,10,5,0,0, MGS3 13,7,0,0,0, MGS4 14,6,0,0,0, MGS5 12,8,0,0,0. The two groups of MGS1, MGS2, MGS3 and MGS4 had no statistically significant difference(P > 0.05), but MGS5 in the treatment group was lower than that in the control group(P < 0.05). At the end of 3 months, the recurrence of chronic subdural hematoma among the control group was 5, but there was none in the treatment group. And the recurrence in the treatment group were lower than that in the control group(P < 0.05).Conclusion: Simvastatin can reduce the amount of postoperative residual hematoma in patients with chronic subdural hematoma, improve the functional status of the brain in the patients and reduce the postoperative recurrence rate of CSDH.