Abstract:【Objective】 To investigate the clinical effect of craniotomy hematoma removal combined with extraventricular drainage in the treatment of hypertensive intracerebral hemorrhage into ventricle . 【Methods】 A retrospective analysis was performed on 100 patients with hypertensive cerebral hemorrhage who underwent surgery in our hospital from January 2016 to May 2018. Among them, 50 patients in the observation group were treated with craniotomy hematoma evacuation and extraventricular drainage, while 50 patients in the control group were treated with simple craniotomy hematoma clearance only. Glasgow coma score (GCS) and intracranial pressure (ICP) were compared between the two groups at different time points before and after surgery. The serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and high mobility group box 1 protein (HMGB-1) levels of the two groups were analyzed before and 2 weeks after surgery. Prognosis and surgical complications were evaluated by the modified Rankin scale questionnaire (MRS) at 6 months postoperatively. 【Results】 There were no significant differences in GCS scores and ICP measurements between the two groups before and 1 day after surgery (P>0.05). The GCS scores of the observation group at 3 days and 7 days after surgery were higher than those of the control group, while the ICP values of the observation group were lower than those of the control group (P<0.05). There was no significant difference between the two groups in the determination of NT-proBNP and HMGB1 before operation (P>0.05). At 2 weeks after surgery, the levels of NT-proBNP and HMGB1 in the observation group were lower than those in the control group (P<0.05). At 3 months after operation, the prognosis rate of the observation group was 58.00% (29/50), which was higher than that of group B (38.00%, 19/50). The difference was statistically significant (χ2=4.006, P=0.045<0.05). The complication rate in the observation group was 14.00% (7/50) , which was lower than 22.00% (11/50) in the control group, however, the difference was not statistically significant (χ2=4.006,P=0.298>0.05). 【Conclusion】 In patients with hypertensive cerebral hemorrhage breaking into the ventricle, the effect of treatment with craniotomy hematoma evacuation combined with extraventricular drainage is superior to the treatment with extraventricular drainage alone. It is beneficial to the recovery of blood-brain barrier and the prognosis of patients.