Analysis Of Related Factors For Recurrence Of Chronic Subdural Hematoma And Research On Application Of Atorvastatin In Patients With Recurrence

Objective In the same group of patients with chronic subdural hematoma(CSDH)after surgery,it can reduce interfering factors,more accurately and comprehensively analyze the factors affecting recurrence,and verify the effectiveness of atorvastatin in reducing recurrence in patients with chronic subdural hematoma after the first operation.At the same time,to explore whether atorvastatin can reduce recurrence by applying atorvastatin to patients with recurrent chronic subdural hematoma after surgery.Methods Selected 155 patients with first confirmed CSDH who met the inclusion criteria and were treated by neurosurgery in Lianyungang Second People’s Hospital and First People’s Hospital from September 2017 to March 2020,and retrospectively analyzed the general information of the patients,and imaging performance,laboratory examination,operation method,postoperative total drainage volume,whether to take atorvastatin after surgery etc.At the same time,combined with 25 cases of recurrence after the first confirmed treatment and 20 cases of recurrence after treatment in the outside hospital.At the same time,combined with 25 cases of recurrence after the first operation and 20 cases of recurrence after the outside hospital operation,the efficacy of atorvastatin in patients who relapsed after the second operation was analyzed.Univariate analysis and multivariate Logistic regression were used to analyze the risk factors for recurrence after the first operation,and univariate analysis was used to analyze the efficacy of atorvastatin in patients with chronic subdural hematoma after the first operation and patients with recurrent chronic subdural hematoma after the second operation.Results The 155 cases diagnosed for the first time and 45 cases of recurrence were followed up for 3 months after surgery.The number of recurrence cases was 25 cases(16.1%)and 10 cases(22.2%).Univariate analysis was performed in 155 patients with CSDH diagnosed for the first time.Preoperative anticoagulant use,preoperative antiplatelet drug use,brain atrophy,postoperative total drainage volume,mixed density,postoperative intracranial pneumatosis,and preoperative fibrinogen degradation products(FDP)value,postoperative oral administration of atorvastatin,postoperative drainage volume and surgical methods were statistically significant(P<0.05).Multivariate logistic regression results showed that mixed density(P=0.016,OR=4.847,95%CI=1.339～7.555),postoperative oral administration of atorvastatin(P<0.001,OR=0.054,95%CI=0.012～0.248),preoperative fibrinogen degradation products(P<0.001,OR=0.011,95%CI=1.021～21.139),postoperative drainage volume(P=0.019,OR=4.483,95%CI=1.278～15.731)and surgical methods(P=0.002,OR =12.595,95%CI=2.534～62.616)are factors affecting recurrence.In addition,a univariate analysis of atorvastatin in patients with recurrence after reoperation found that the effect on recurrence was statistically significant(P<0.05).Conclusion 1.In this paper,through a retrospective study of the same sample,the factors related to the recurrence of CSDH patients after primary surgery were obtained more accurately and comprehensively in the case of excluding relevant interfering factors.Preoperative use of anticoagulants and antiplatelets,brain atrophy,preoperative hematoma volume ≥ 100 ml,mixed density,preoperative fibrinogen degradation product value,intracranial gas accumulation,postoperative total drainage volume and surgical methods are related factors affecting the recurrence of chronic subdural hematoma after the first operation.Mixed density,preoperative fibrinogen degradation products value,postoperative total drainage volume and surgical method were independent factors affecting recurrence.2.Univariate analysis verified that atorvastatin was effective in reducing the recurrence of patients with chronic subdural hematoma after the first operation,and multivariate analysis showed that atorvastatin was an independent protective factor affecting the recurrence of patients with chronic subdural hematoma after the first operation.3.Univariate analysis showed that atorvastatin was still effective in reducing recurrence after reoperation in patients with recurrent chronic subdural hematoma.4.By studying the recurrence-related factors of the same sample and verifying the effect of atorvastatin on reducing the recurrence of patients after the first postoperative,the relevant factors of the treatment process can be intervened before,during and after the operation,and atorvastatin can be given in time.As an intervention to reduce recurrence in the first postoperative period.Atorvastatin is also effective in patients with recurrence after reoperation,which can reduce the risk of recurrence,suggesting that both patients with first diagnosis after surgery and patients with recurrence after reoperation can try to use Atorvastatin to reduce recurrence.