目的:比较不同时间窗微创穿刺引流术治疗高血压脑出血的疗效和安全性。方法:选择烟台市烟台山医院神经外科自2016年1月至2019年12月行微创穿刺引流术治疗的98例高血压脑出血患者，按手术时间分为超早期组(发病<3 h内手术)、早期组(发病3~24 h内手术)、急性期组(发病24~72 h内手术)，回顾性分析患者的临床资料，比较3组患者的血肿清除情况、术后14 d肌力和意识改善情况、美国国立卫生研究院卒中量表(NIHSS)评分和再出血情况。结果:超早期组中低、中等、高血肿清除率患者分别为11例(84.6%)、2例(15.4%)、0例。早期组中低、中等、高血肿清除率患者分别为20例(33.9%)、32例(54.2%)、7例(11.9%)。急性期组中低、中等、高血肿清除率患者分别为8例(30.8%)、14例(53.8%)、4例(15.4%)。早期组及急性期组患者的血肿清除情况较超早期组患者好。术后14 d，早期组及急性期组患者中肌力改善者所占比例高于超早期组，早期组患者中意识改善者所占比例高于超早期组及急性期组，早期组患者的NIHSS评分较超早期组及急性期组患者明显降低，差异均有统计学意义(n P<0.05)。术后再出血患者共4例，其中超早期组1例，早期组3例。n 结论:脑出血患者在发病3~24 h行微创穿刺引流术治疗时血肿清除情况较为理想，术后恢复相对较好。“,”Objective:To compare the efficacy and safety of minimally invasive puncture and drainage for hypertensive cerebral hemorrhage at different time windows.Methods:A total of 98 patients with spontaneous cerebral hemorrhage underwent minimally invasive puncture and drainage in our hospital from January 2016 to December 2019 were chosen. These patients were divided into 3 groups in accordance with operation time: an ultra-early-stage group (accepted surgery within3 h of onset), an early-stage group (accepted surgery within 3-24 h of onset), an acute-stage group (accepted surgery within 24-72 h of onset); the clinical data of these patients were retrospectively analyzed. The hematoma clearance, muscle strength improvement 14 d after surgery, consciousness improvement 14 d after surgery, National Institutes of Health Neurological Deficit Scale (NIHSS) scores 14 d after surgery, and re-hemorrhage were compared among the 3 groups.Results:In the ultra-early-stage group, there were 11 patients (84.6%), 2 patients (15.4%) and 0 patients (0%) with low, medium and high hematoma clearance rates. In the early-stage group, there were 20 patients (33.9%), 32 patients (54.2%) and 7 patients (11.9%) with low, medium and high hematoma clearance rates. In the acute-stage group, 8 patients (30.8%), 14 patients (53.8%) and 4 patients (15.4%) had low, medium and high hematoma clearance rates. The hematoma clearance rate in the early group and the acute group was higher than that in the ultra-early group. Fourteen d after surgery, the proportion of patients with muscle strength improvement in the early-stage group and acute-stage group was significantly higher than that in the ultra-early-stage group (n P<0.05); the proportion of patients with consciousness improvement in the early-stage group was significantly higher than that in the ultra-early-stage group and acute-stage group (n P<0.05); NIHSS scores of patients in the early-stage group were significantly lower than those in the ultra-early stage group and acute-stage group (n P<0.05). There were 4 patients with postoperative re-hemorrhage, including one from the ultra-early-stage group and 3 from the early group.n Conclusion:In patients with cerebral hemorrhage, hematoma clearance is relatively good and postoperative recovery is good when minimally invasive puncture and drainage is performed within 3-24 h of onset.