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目的:探讨神经内镜和开颅显微镜下血肿清除术治疗丘脑出血的疗效的差异。方法:对盐城市第一人民医院神经外科自2016年9月至2019年3月收治的83例丘脑出血患者，分别采用神经内镜下血肿清除术治疗44例及采用开颅显微镜下血肿清除术治疗39例，并按照患者入院时格拉斯哥昏迷量表(GCS)评分分为55例重症和28例轻症。对比分析2种手术的疗效和安全性，并采用格拉斯哥预后量表(GOS)评估患者发病后1年随访时的康复情况。结果:与开颅显微镜下血肿清除术治疗组比较，神经内镜下血肿清除术治疗组患者的术中出血量较少[(284.90±31.74) mL n vs. (45.70±6.94) mL]，住院时间较短[(18.40±2.75) d n vs. (14.70±2.13) d]，癫痫的发生率较低(15.4% n vs. 2.3%)，差异均有统计学意义(n P<0.05)。发病后1年，在存活的重症患者中，神经内镜下血肿清除术治疗组患者的GOS评分[(2.99±0.48)分]明显高于开颅显微镜下血肿清除术治疗组[(2.64±0.41)分]，差异有统计学意义(n P<0.05)。n 结论:与开颅显微镜下血肿清除术比较，神经内镜下血肿清除术治疗丘脑出血具有微创、视野好、高效、术后恢复快等优点。“,”Objective:To explore the effects of hematoma removal by neuroendoscopy or craniotomy on thalamic hemorrhage.Methods:Eighty-three patients with thalamic hemorrhage, admitted to our hospital from September 2016 to March 2019, were chosen in our study; 44 patients accepted hematoma removal by neuroendoscopy and 39 patients accepted hematoma removal by craniotomy under microscope. These patients were divided into severe type (n n=55) and mild type (n n=28) according to Glasgow coma scale scores at admission. The efficacy and safety of the two procedures were compared. Patients were followed up until one year after onset, and their recovery was assessed by Glasgow outcome scale (GOS).n Results:As compared with those in the craniotomy group, patients in the neuroendoscopy group had significantly small volume of intraoperative blood loss ([284.90±31.74] mL n vs. [45.70±6.94] mL), significantly shorter hospital stays ([18.40±2.75] dn vs. [14.70±2.13] d), and statistically lower incidence of epilepsy (15.4% n vs. 2.3%, n P<0.05). In critical survived patients, the GOS scores in the endoscopic group were 4.99±0.48 until one year after onset, which were significantly higher than those in the craniotomy group (2.64±0.41,n P<0.05).n Conclusion:As compared with hematoma removal by craniotomy, that by neuroendoscopy has the advantages of minimal invasion, good visual field, and high efficiency in the treatment of thalamic hemorrhage.