探讨封闭式钻孔引流联合阿托伐他汀治疗慢性硬膜下血肿的疗效。

前瞻性收集联勤保障部队第九〇七医院神经外科自2018年1月至2022年12月收治的慢性硬膜下血肿患者87例，采用随机数字表法分为观察组（45例）和对照组（42例）。对照组采取传统的微创钻孔引流术，观察组采取封闭式钻孔引流，术后联合阿托伐他汀治疗。对比2组患者的手术时间、术后症状改善情况、拔管时间、术前及术后3个月的神经功能[美国国立卫生院卒中量表（NIHSS）评分]和生活活动能力（ADL）改善情况、术后并发症及血肿复发情况。

观察组中38例（84.4%）的患者手术时间为10~15 min，对照组中40例（95.2%）的患者手术时间>15 min，2组比较差异有统计学意义（P<0.05）。术后头痛、头晕加重者中，观察组5例，对照组28例，差异有统计学意义（P<0.05）。观察组术后拔管时间大多在术后第1天，对照组拔管时间集中在术后第3~4天，差异有统计学意义（P<0.05）。术后1周，观察组硬膜下积液发生率低于对照组，但差异无统计学意义（P>0.05）；颅内积气的发生率低于对照组，差异有统计学意义（P<0.05）。术后3个月，观察组的NIHSS评分低于对照组，ADL评分高于对照组，差异有统计学意义（P<0.05）。术后6个月，观察组的术后复发率低于对照组，差异有统计学意义（P<0.05）。

封闭式钻孔引流联合阿托伐他汀治疗慢性硬膜下血肿可缩短治疗时间，提高患者神经功能改善程度，降低术后并发症及复发率。

To explore the therapeutic efficacy of closed drilling drainage combined with Atorvastatin in the treatment of chronic subdural hematoma.

A prospective collection of 87 cases of chronic subdural hematoma admitted to Neurosurgery Department of the 907^th Hospital of Joint Support Force of PLA from January 2018 to December 2022 were prospectively collected and randomly divided into the observation group (n=45) and the control group (n=42). The control group received traditional minimally invasive drilling and drainage surgery, while the observation group received closed drilling and drainage, followed by postoperative treatment with Atorvastatin. The surgical time, postoperative symptom improvement, extubation time, preoperative and postoperative neurological function (NIHSS) score and activity of life (ADL) improvement, postoperative complications, and hematoma recurrence between two groups were compared.

Thirty-eight patients (84.4%) in the observation group had surgery time of 10-15 min, while 40 patients (95.2%) in the control group had surgery time>15 min, the difference between the two groups was statistically significant (P<0.05). Among patients with worsening postoperative headache and dizziness, there were 5 cases in the observation group and 28 cases in the control group, with a statistically significant difference (P<0.05). The observation group mostly underwent extubation on the 1^st postoperative day, while the control group mostly underwent extubation on the 3^rd to 4^th postoperative day, with a statistically significant difference (P<0.05). After 1 week of surgery, the incidence of subdural effusion in the observation group was lower than that in the control group, but the difference was not statistically significant (P>0.05). The incidence of intracranial gas accumulation was lower than that in the control group, and the difference was statistically significant (P<0.05). After 3 months of surgery, the NIHSS score of the observation group was significantly lower than that of the control group, and the ADL score was significantly higher than that of the control group, with statistical significance (P<0.05). After 6 months of surgery, the postoperative recurrence rate in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P<0.05).

Closed drilling drainage combined with Atorvastatin can shorten the treatment time of chronic subdural hematoma, improve the degree of neurological improvement, and reduce postoperative complications and recurrence rates.