Abstract: ［Abstract］ Objective To study the treatment of basal ganglia by neuro?endoscopic hematoma removal and traditional craniotomy hematoma removalin the clinical effect difference of cerebral hemorrhage. Methods The patients with basal ganglia hemorrhage admitted to our department on January 1， 2017 and August 31， 2018 were selected as the research objects. The patients were divided into the craniotomy group and the endoscopic group based on the tension?matching principle， with 49 cases and 53 cases respectively， to ensure the comparability of the two groups of patients′ conditions. Traditional craniotomy hematoma clearance was performed in the craniotomy group， and complete endoscopic hematoma clearance was performed in the endoscopic group. Then， intraoperative and postoperative information， postoperative complications， and clinical prognosis of the two groups of patients were compared to evaluate the advantages and disadvantages of the two surgical methods. Results There were no statistically significant differences in operative time， hematoma clearance rate and rebleeding incidence between the endoscopic group and the craniotomy group （P>0.05）， but the intraoperative blood loss was lesser， and the GCS score of the endoscopic group was higher than that of the craniotomy group at 2 week and 3 month after surgery， with statistically significant differences （P<0.05）. There were no statistically significant differences between the two groups in postoperative pulmonary infection， urinary tract infection， venous thrombosis， gastrointestinal bleeding， intraoperative oral infection and postoperative epilepsy （P>0.05）， but the incidence of postoperative cerebral edema was lower in the endoscopic group than in the craniotomy group （P<0.05）. The GOS score and ADL score of the endoscopic group were both higher than those of the craniotomy group at 3 months postoperatively， and the difference was statistically significant （P<0.05）. Conclusion Endoscopic hematoma removal is superior to traditional hematoma removal in the surgical treatment of basal ganglia hemorrhage.

Key words: endoscopy, traditional craniotomy, basal ganglia hemorrhage

摘要： ［摘要］ 目的 研究神经内镜下血肿清除术和传统开颅血肿清除术治疗基底节脑出血的临床疗效差异。方法 选取2017年01月01日至2018年08月31日期间我科收治的基底节脑出血患者作为研究对象，采用倾向性匹配原则分为开颅组和内镜组，分别为49例和53例，以保证两组患者病情的可比性。开颅组进行传统开颅血肿清除术，内镜组进行完全内镜下血肿清除术，然后比较两组患者的术中和术后相关信息、术后并发症差异、临床预后差异，以评价两种手术方式的优弊。结果 开颅组患者和内镜组患者在手术用时、血肿清楚率、再出血发生率上并无统计学差异（P>0.05），但内镜组患者在术中出血量低于开颅组，术后2周、3个月时GCS评分要高于开颅组，差异有统计学意义（P<0.05）；开颅组和内镜组患者术后出现肺部感染、泌尿系感染、静脉血栓、消化道出血、术口感染、术后癫痫上无统计学差异（P>0.05），但在术后脑水肿的发生率上内镜组低于开颅组，差异有统计学意义（P<0.05；内镜组患者在术后3个月时的GOS评分、ADL评分平均秩次均高于开颅组，差异有统计学意义（P<0.05）。结论 对基底节脑出血的手术治疗，内镜下血肿清除术优于传统血肿清除术。

关键词: 神经内镜, 传统开颅, 基底节脑出血