目的 分析对比神经内镜微创手术和开颅血肿清除术对高血压脑出血患者的治疗效果。方法 选择2021年4月—2024年4月收治的高血压脑出血患者共46例,按照手术方式不同分为两组,对照组（n=30）行开颅血肿清除术,观察组（n=16）采用神经内镜微创手术。比较两组临床疗效、手术时间及术中出血量、神经功能损伤程度[采用美国国立卫生研究院卒中量表（NIHSS）评估]改善情况、术后并发症发生情况。结果 治疗总有效率,观察组高于对照组（P<0.05）。观察组手术时间短于对照组,术中出血量少于对照组（均P<0.05）。神经功能评分（NIHSS评分）,两组治疗前无统计学差异（P>0.05）,治疗后均较治疗前降低,且观察组更低（P<0.05）。观察组并发症总发生率低于对照组,差异显著（P<0.05）。结论 神经内镜微创手术对于高血压脑出血,可在短时间内发挥显著作用效果,安全性高,对患者神经功能改善具有促进作用,值得推广应用。

Objective To analyze and compare the therapeutic effects of minimally invasive neuroendoscopic surgery and craniotomy hematoma removal surgery in patients with hypertensive intracerebral hemorrhage. Methods A total of 46 patients with hypertensive intracerebral hemorrhage admitted from April 2021 to April 2024 were selected and divided into two groups according to different surgical methods. The control group （n=30） underwent craniotomy hematoma removal surgery, while the observation group （n=16） underwent minimally invasive neuroendoscopic surgery. Improvement in clinical efficacy, surgical time, intraoperative bleeding volume, and degree of neurological damage [assessed by the National Institutes of Health stroke scale （NIHSS）], and postoperative complications were compared between the two groups. Results The total effective rate of treatment in the observation group was higher than that in the control group （P<0.05）. The operation time was shorter and the intraoperative blood loss was less in the observation group than that in the control group （P<0.05）. There was no significant difference in the neurological function score （NIHSS） between the two groups before treatment （P>0.05）. After treatment, the NIHSS scores in both groups decreased compared to those before treatment, and the observation group had a lower score （P<0.05）. Compared with the control group, the observation group had a lower incidence of complications （P<0.05）. Conclusion Neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage can achieve the desired effect in a short period of time, with high safety and neurological function benefits. It is worth promoting and applying.