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目的：对比经外侧裂入路与经颞中回入路手术治疗进展性基底节区脑出血的优劣性。方法将122例符合标准的进展性基底节区脑出血患者随机分为A组和B组，A组经外侧裂入路手术，B组经颞中回入路手术，对2组患者术前临床资料、术中情况及术后情况进行对比。结果术前临床资料对比差异无统计学意义；术中情况对比：经外侧裂组较经颞中回组暴露血肿容易、止血确切、去骨瓣减压例数少，2组对比差异有统计学意义（P＜0.05）；术后情况对比：经外侧裂组较经颞中回组清除血肿理想、再出血例数少、术后脑水肿轻，2组对比差异有统计学意义（P＜0.05）。结论经外侧裂岛叶入路治疗高血压壳核出血与经颞叶皮质入路比较，手术创伤较小，清除血肿更彻底，术后脑水肿较轻，更符合微创理念，值得在临床推广。“,”Objective To compare the microsurgical treatment of progressive basal ganglia hemorrhage through lateral fissure approach or middle temporal gyrus approach. Methods A total of 122 patients with progressive basal ganglia hemorrhage were randomly divided into Groups A and B, which underwent surgery through lateral fissure approach and middle temporal gyrus approach, respectively. Both groups were compared for clinical data before, during and after surgery. Results No significant differences were found in preoperative conditions between the two groups. During operation, compared with Group B, the hematoma cavity was remarkably easier to reach in Group A, with quicker inhibition of bleeding and less cases of decompressive craniectomy (P<0.05). After operation, Group A showed markedly less hematoma residual, re-bleeding incidence and encepheladema than Group B (P<0.05). Conclusion Compared with middle temporal gyrus approach, treatment of basal ganglia hematoma via lateral fissure approach has minimal invasion, with less hematoma residual and encepheladema, which is worthy of promotion in clinical setting.