目的　探讨微创小骨窗血肿清除加用尿激酶溶解血肿治疗高血压脑出血的效果。方法　将 32例入院的高血压脑出血病例在头颅CT片指导下行颞部直切口 ,小骨窗 2 0～ 3 0cm ,直视下吸除大部血肿 ,活动性出血予以电凝止血。血肿腔放置硅胶管 ,手术后 3d引流管注入 1万U尿激酶 ,再引流陈旧溶解的血肿液 ,并与大骨瓣开颅血肿清除术的效果相比较。结果　 32例中 ,18例完全恢复 ,半自理 8例 ,优良率 81 3% ,偏瘫 4例 ,无植物生存 ,死亡 2例 ,病死率 6 %。与前期大骨瓣开颅血肿清除术相比较有良好的效果。结论　小骨窗微创血肿清除加尿激酶血肿腔溶解血肿的结合 ,最佳化地发挥了各自的优势 ,同时避免了其缺点。 Objective To investigate the effect of minimally invasive small-bone window hematoma removal plus urokinase-dissolved hematoma in the treatment of hypertensive intracerebral hemorrhage. Methods Twenty-two cases of hypertensive intracerebral hemorrhage admitted under the direction of the head CT were performed direct temporal incision and small bone window 20 ~ 30 cm. Most hematomas were removed under direct vision, and active hemorrhage was given for coagulation and hemostasis. Silicone tube was placed in the hematoma cavity. Thirty thousand U of urokinase was infused into the drainage tube after the operation, and then the old dissolving hematoma fluid was drained and compared with the effect of craniotomy in the large bone flap. Results Among the 32 cases, 18 cases were completely recovered, 8 cases were semi-self-managed, the excellent and good rate was 81.3% and 4 cases were hemiplegia. There was no plant survival and 2 deaths with a case fatality rate of 6%. Compared with the preoperative large craniotomy craniotomy compared with good results. Conclusion Small bone window minimally invasive hematoma removal combined with urokinase hematoma cavity dissolved hematoma, optimized to play their respective advantages, while avoiding its shortcomings.