目的：比较立体定向血肿引流术与神经内镜治疗高血压脑出血（HICH）的临床疗效。方法：回顾性收 集HICH患者70 例，采用神经内镜治疗的35 例为内镜组，采用立体定向血肿引流术治疗的35 例为定向组， 比较2 组相关手术指标、术后并发症、术后1 月死亡率及术后6 月格拉斯哥预后评分（GOS）。结果：与内镜组 比较，定向组的手术时间较短（t=－9.483，P=0.000），血肿清除率低于内镜组（t=－11.105，P=0.000）；内镜组 术后无再出血患者，定向组的再出血率显著高于内镜组（χ2=9.032，P=0.003），内镜组各项并发症发生率及死 亡率与定向组相比无统计学差异（P>0.05），术后6 月内镜组远期GOS评分优于定向组（P<0.05）。结论：采用 神经内镜下手术治疗HICH，疗效优于立体定向血肿引流术。

To compare the clinical curative effect of stereotactic evacuation of hematoma and neuroendoscopy in the treatment of hypertensive intracerebral hemorrhage (HICH). Methods: A total of 70 patients with HICH were retrospectively enrolled in the study. Among them, 35 patients treated by neuroendoscopy were included in the neuroendoscopy group and 35 patients treated by stereotactic evacuation of hematoma were included in the stereotactic group. The relevant surgical indexes, postoperative complications, mortality rate within 1 month of surgery, and Glasgow Outcome Scale (GOS) score at 6 months after surgery were compared between the two groups. Results: Compared to that of the neuroendoscopy group, the surgical time of the stereotactic group was significantly shorter (t=－9.483, P=0.000) and the hematoma clearance rate was significantly lower (t=－ 11.105, P=0.000). There was no incidence of rebleeding in the neuroendoscopy group after surgery, and the rebleeding rate of the stereotactic group was significantly higher than that of the neuroendoscopy group (χ2=9.032, P=0.003). There was no significant difference in the incidence of complications or mortality rate between the two groups (P>0.05). The long-term GOS score of the neuroendoscopy group at 6 months after surgery was significantly better than that of the stereotactic group (P<0.05). Conclusion: Neuroendoscopic surgery is more effective than stereotactic evacuation of hematoma in the treatment of HICH.