To compare the clinical advantages and disadvantages of hematoma removal through lateral fissure under microscope and conventional hematoma removal through cortical craniotomy in the treatment of spontaneous basal ganglia cerebral hemorrhage.

Sixty patients with basal ganglia cerebral hemorrhage admitted to neurosurgery department of The People’s Hospital of Shanwei City from January 2017 to December 2018 were selected as the objects, and they were randomly divided into observation group (30 cases) and control group (30 cases). Patients in the observation group were treated with hematoma removal through the lateral fissure approach under the microscope, while patients in the control group were treated with conventional hematoma removal through the cortical craniotomy. The differences in surgical indicators, postoperative complications, inflammatory factors index, and clinical prognosis between the two groups were compared.

There was no significant difference in preoperative GCS score, preoperative hematoma volume, and hematoma clarity between the two groups (P>0.05). The intraoperative blood loss, postoperative waking time, hospitalization time and hospitalization cost of the observation group were less than that of the control group, with statistically significant differences (P<0.05). The incidence of epilepsy, electrolyte disturbance and pulmonary infection in the observation group was lower than that in the control group, with statistically significant differences (P<0.05). There were no statistically significant differences in rebleeding, intracranial infection, stress gastrointestinal bleeding and deep vein thrombosis between the two groups (P>0.05). Serum levels of inflammatory factors interleukin-1, tumor necrosis factor-α, and C-reactive protein in the observation group were all lower than those in the control group, with statistically significant differences (P<0.05). There was no significant difference in the mean rank of quality of life score between the two groups at the 3^rd month (P>0.05), while the mean rank of the observation group at the 6^th and 12^th month was smaller than that of the control group, with statistically significant difference (P<0.05).

Among spontaneous basal ganglia cerebral hemorrhage hematoma removal surgery approaches, compare to traditional transcortical approach craniotomy, under microscope through lateral fissure approach can reduce the surgical blood loss, shorten the waking time and postoperative hospital stay, reduce the incidence of postoperative complications and inflammatory factors level, saves medical cost, and improve the patients’ long-term quality of life.