摘要目的:比较经颞部与经额部入路微创钻孔引流术治疗高血压脑出血(HCH)的效果。方法:队列研究。抽取2019年1月至2022年12月漯河市第二人民医院收治的HCH患者84例，按随机数字表法分为经额组和经颞组，每组42例。经额组采取经额部入路微创钻孔引流术，经颞组采取经颞部入路微创钻孔引流术。比较两组围术期指标、血肿残余量、神经功能[美国卫生研究所卒中评分表(NIHSS)评分、中国卒中量表(CSS)评分]、并发症发生率。结果:经额组与经颞组术中操作时间、术中出血量、意识恢复时间、住院天数比较差异未见统计学意义( P>0.05)。术后3、7 d，经额组血肿残余量低于经颞组( P<0.05)。术后3、6个月，经额组NIHSS、CSS评分低于经颞组( P<0.05)。经额组并发症发生率(7.14%，3/42)与经颞组(11.90%，5/42)比较差异未见统计学意义( P>0.05)。 结论:经颞部与经额部入路用于HCH患者微创钻孔引流术中均能缩短意识恢复时间和住院天数，减少术中出血量，但经额部入路还能降低血肿残余量，减轻神经缺损现象，且该入路方式不会增加并发症。

abstractsObjective:To compare the effects of minimally invasive trepanation and drainage via transtemporal approach versus transfrontal approach on hypertensive intracranial hemorrhage (HCH).Methods:A total of 84 patients with HCH treated in Luohe Second People’s Hospital from January 2019 to December 2022 were selected for the cohort study. And they were divided into the transfrontal group and the transtemporal group according to random number table method, with 42 cases in each group. The transfrontal group underwent minimally invasive trepanation and drainage via transtemporal approach, while the transtemporal group underwent minimally invasive trepanation and drainage via transtemporal approach. Perioperative indexes, residual hematoma, neurological function assessed by the American National Institutes of Health stroke scale (NIHSS) score and Chinese Stroke Scale (CSS) score, and incidence of complications were compared between the two groups.Results:There were no significant differences in operation duration, intraoperative blood loss, consciousness recovery time and hospital stay between the transfrontal group and the transtemporal group ( P>0.05). Compared with the transtemporal group, the residual volume of hematoma was lower in the transfrontal group at 3 and 7 days after operation ( P<0.05). Compared with the transtemporal group, the scores of NIHSS and CSS were lower in the transfrontal group 3 and 6 months after operation ( P<0.05). There was no significant difference in the incidence of complications between the transfrontal group (7.14%, 3/42) and the transtemporal group (11.90%, 5/42), P>0.05. Conclusions:Both transtemporal approach and transfrontal approach in minimally invasive trepanation and drainage for HCH patients can not only shorten the time of consciousness recovery and length of hospital stay, but also reduce the intraoperative blood loss; in addition, transfrontal approach surgery can reduce the residual amount of hematoma and alleviate nerve defects, without increasing the occurrence of complications.