Clinical Studies For The Treatment Of Chronic Subdural Hematoma Combined Atorvastatin With Minimally Invasive Puncture

Background and purpose The main treatment of chronic subdural hematoma(CSDH)is Surgical intervention,but the operation has corresponding risks and complications,and especially there is a certain recurrence rate.It had been reported that atorvastatin plays a role in conservative treatment of CSDH in recent years,The purpose of this study is to identify the effectiveness of atorvastatin in patients with CSDH after minimally invasive puncture.Methods Sixty-four eligible patients with unilateral CSDH were selected from September 2015 to October 2017.which were random allocated.32 patients started to take atorvastatin on the of surgery(experimental group),and the others did not take atorvastatin(control group).The hematoma volume was calculated by cranial CT examination on the next day,1 week,1 month,2 months,3 months and 6 months respectively.For those patients with the thickness of hematoma more than 10mm or midline shift more than 5mm,surgical treatment was performed again.The number of recurrence and reoperation cases during the follow-up of six months was collected.SPSS 19.0 software was used to analyze the data,and P<0.05 had statistical significance.Results Sixty-four patients were grouped contrasted,(1)There was no significant difference between the experimental group and the control group in admission sex,age,preoperative hematoma side,hematoma density,hematoma volume,hematoma thickness,midline deviation and Markwalder grade(P>0.05).(2)The hematoma volume of the experimental group on the next day,1 week,1 month,2months,3 months and 6 months were respectively 42.88 ± 7.22 ml,21.49± 2.29 ml,12.92 ± 2.35 ml,7.95 ±4.65 ml,3.49±3.80 ml;and the control group were 43.35±7.64 ml,22.38±1.60 ml,20.93±16.43 ml,15.84±14.08 ml,6.56±3.78ml.There was no significant difference in hematoma volume between the two groups on the next day and one week after surgery(P>0.05).However,the hematoma volume of the experimental group was significantly decreased at 1 month,3 months and 6 months after operation(P<0.05).(3)There was no significant difference in the Markwalder grade between the experimental group and the control group on the following day,1 week and 1 month after operation(P>0.05).However,the Markwalder grade of the experimental group was significantly higher than that of the control group in 3 months and 6 months(P<0.05).(4)There was one recurrence in the experimental group and 8 in the control group.There were no case in the experimental group and 6 cases in the control group need reoperation,both of which were statistically different(P<0.05)?During the experiment,all patients regularly reviewed blood routine,liver and kidney function,etc.,and no adverse reactions with atorvastatin were observed.ConclusionsBy comparing and summary,we think that minimally invasive puncture is an effective method for treatment of CSDH,but there are still some disadvantages such as recurrence,the treatment of atorvastatin combined minimally invasive puncture has the following obvious advantages:promote the postoperative absorption of hematoma;improve the postoperative neurological function and clinical symptoms of patients with CSDH;reduce the recurrence rate and decrease the risk of reoperation.