目的 探讨微创血肿穿刺引流术与传统开颅血肿清除术用于治疗高血压脑出血的临床价值。方法 选取2017年1月—2022年12月进行微创血肿穿刺引流术治疗的41例高血压脑出血患者作为微创组,选取同期进行传统开颅血肿清除术治疗的46例高血压脑出血患者作为开颅组,对两组患者血肿清除率、神经损伤情况、生活自理能力、生存质量及不良反应发生情况进行对比分析。结果 两组间血肿清除率比较,差异无统计学意义（P>0.05）,微创组不良反应发生率显著低于开颅组（P<0.05）。两组患者术前美国国立卫生研究院卒中量表（NIHSS）、日常生活活动能力（ADL）、健康调查简表（SF-36）评分比较,差异无统计学意义（P>0.05）,术后NIHSS、ADL、SF-36评分均较术前显著改善（P<0.05）,且术后各时间点微创组患者NIHSS、ADL、SF-36评分均显著优于开颅组（P<0.05）。结论 与传统开颅血肿清除术相比,微创血肿穿刺引流术用于治疗高血压脑出血可显著降低术后并发症的发生,同时还可提升患者远期预后。

Objective To explore the clinical values of minimally invasive puncture and drainage of hematoma and traditional craniotomy in the treatment of hypertensive intracerebral hemorrhage （HIH）. Methods A total of 41 patients with HIH treated with minimally invasive puncture and drainage of hematoma from January 2017 to December 2022 were selected as Mi group, and at the same time, 46 patients with HIH treated with traditional craniotomy were selected as Tc group. The hematoma clearance rate, nerve injury, self-care ability, quality of life, and adverse reactions of the two groups were compared. Results There was no significant difference in the clearance rate of hematoma between the two groups （P>0.05）. The incidence of adverse reactions in the Mi group was significantly lower than that in the Tc group （P<0.05）. The National Institutes of Health stroke scale （NIHSS）, activities of daily living （ADL）, and short form health survey （SF-36） scores were not significantly different between the two groups before operation （P>0.05）, but were significantly improved in the two groups after operation （P<0.05）, and the scores of NIHSS, ADL, and SF-36 in the Mi group were significantly better than those in the Tc group （P<0.05）. Conclusion Compared with traditional craniotomy, minimally invasive puncture and drainage of hematoma can significantly reduce the incidence of postoperative complications and improve the long-term prognosis of patients with HIH.