Clinical Study Of Stereotactic Minimally Invasive Surgery In ICH Evacuation Combined With Atorvastatin In Improving The Neurofunction Of Patients With Intracerebral Hemorrhage

Objective: To observe the effects of atorvastatin combined with stereotactic minimally invasive intracranial hematoma removal on patients with cerebral hemorrhage.Methods: A total of 229 patients were included in the spontaneous intracerebral hemorrhage patients in the Guizhou Medical University Affiliated Hospital from August 01,2018 to January 31,2019.The 229 patients were divided into two parts according to whether they were suitable for surgical treatment.Non-surgical patients with a total of 131 cases were divided into drug control group(conventional drug treatment)84 cases and statin treatment group(conventional drug& atorvastatin calcium tablets)47 cases.Patients with surgery were divided into the minimally invasive surgery group(stereotactic minimally invasive surgery &conventional drug treatment)75 cases and the combined treatment group(stereotactic minimally invasive surgery & conventional drugs & atorvastatin calcium tablets)23cases.All of them were treated according to Chinese guidelines for intracerebral hemorrhage.The treatment of atorvastatin started with 20mg/day within 24 hours after admission and then continued for 90 days at a dose of 20mg/day.All patients were given other conventional treatments such as blood pressure lowering,blood sugar control,symptomatic treatment and so on.The main outcome indicators during follow-up were mRS scores and proportion of patients with adverse outcomes at 90 days.The secondary outcome measure was the change in the hematoma volume of the patient after treatment.All patients recorded and counted baseline data and routine and related examinations at admission,observed and followed the GCS score,NIHSS Score,m R S score,and CT hematoma volume.Follow-up of cerebral hemorrhage complications such as liver damage,rebleeding,respiratory failure,vegetative state,and secondary epilepsy occurred.Results: There were 31 cases(65.96%)with good outcomes in the statin treatment group and 31 cases(36.90%)with good outcomes in the drug control group.The difference between the two groups was statistically significant.Follow-up observations showed that 27 deaths(32.14%)in the drug control group were significantly higher than 6(12.77%)deaths in the statin treatment group,and the difference was statistically significant.There was no significant difference between the two groups in hematoma volume at 1 week,2 weeks after treatment,and at discharge.At the end of the follow-up,the adverse reactions of the statin-treated group and the drug control group were similar.There were no patients who needed to discontinue the adverse reactions of statins,and the risk of recurrent cerebral hemorrhage in the statin group was not significantly increased.At the end of the 90-day follow-up,12 patients(52.17%)with good prognosis in the combined treatment group were higher than 11 patients(14.67%)with good prognosis in the minimally invasive surgery group,the difference was statistically significant;Five patients(21.74%)died in the combined treatment group than 34 patients(45.33%)in the minimally invasive surgery group,and the difference was initially not considered statistically significant.There were no significant differences in GCS scores,NIHSS scores,and hematoma volumes at 1 week,2 weeks,and at discharge.Complications were similar in the two groups,and there was no significant rebleeding tendency in the combination group due to the use of atorvastatin.Conclusion: 1.Atorvastatin may improve the recent neurological function of patients with intracerebral hemorrhage;2.Atorvastatin can reduce the proportion of poor prognosis outcomes and reduce mortality in patients with intracerebral hemorrhage;3.Stereotactic minimally invasive technology combined with atorvastatin treatment may reduce the proportion of adverse outcomes and mortality in patients with intracerebral hemorrhage;4.Atorvastatin can not reduce the volume of hematoma and hepatic function damage,recurrent intracerebral hemorrhage,respiratory failure,vegetative state,and secondary epilepsy complications;5.Atorvastatin does not increase the risk of liver damage and intracranial rebleeding.It is safe.