Objective To investigate the clinical effect of big bone window craniotomy combined with microscope operation treatment of cerebral hemorrhage with cerebral hernia. Methods Retrospective analysis was applied to compare the difference in the mortality and the degree of the morbidity between the microsurgical craniotomy group and traditional craniotomy group. Results The mortality in the microsurgical craniotomy group was 15%, while the mortality rate was 32.5%in traditional craniotomy group the, diffence was .statistically significant. Conclusion The bone window craniotomy combined with microscope operation can rapidly reduce intracranial pressure, and is with minimal trauma hematoma with reduced complications, it greatly reduces the mortality of cerebral hemorrhage complicated with cerebral hernia.%目的：探讨大骨窗开颅联合显微镜下手术治疗高血压性脑溢血合并脑疝的的临床疗效。方法采用回顾性分析方法，比较开颅联合显微镜下手术与传统单纯开颅手术治疗高血压性脑溢血合并脑疝的死亡率及伤残程度。结果开颅联合显微镜下手术组死亡率15.0%（6/40），传统单纯开颅组死亡率32.5%（13/40），差异有统计学意义（P<0.05）。结论大骨窗开颅联合显微镜下手术既能迅速降低颅压，又能用以最小的创伤清除血肿，减少并发症，能降低脑溢血合并脑疝的死亡率，是治疗高血压性脑溢血合并脑疝的较好方法。
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