Abstract: Objective To investigate the safety of minimally invasive surgery in the treatment of intracerebral hemorrhage and the effect on serum cystatin C（Cys-C） and aquaporin 4（AQP4）.Methods 90 patients with hypertensive intracerebral hemorrhage were selected and randomly divided into two groups，each with 45 cases.The observation group received minimally invasive surgery，while the control group received traditional craniotomy.Then surgical related indexes，clinical efficacy and serum Cys-C and AQP4 levels were compared between the two groups.Results The wound length，operation time，intraoperative bleeding volume and hospitalization time of the observation group were better than those of the control group[（3.11±1.03）cm vs（15.48±3.72）cm；（47.34±10.39）min vs（63.96±19.57）min；（15.48±2.52）ml vs（76.93±9.81）ml；（13.28±6.64）d vs（23.76±4.82）d；P<0.05]； The treatment compliance rate and effective rate of the observation group were significantly higher than those of the control group（95.56% vs 77.78%； 93.33% vs 75.56%；P<0.05）.The incidence rate of complication and mortality in the observation group were significantly lower than those in the control group（13.33% vs 28.89%； 2.22% vs 8.89%；P<0.05）.The serum levels of AQP4 and Cys-C in the observation group were significantly lower than those in the control group[（0.04±0.01） mg/L vs（0.22±0.01） mg/L；（0.90±0.03） mg/L vs（1.35±0.16） mg/L；P<0.05].Conclusion The application of minimally invasive surgery has the advantages of small wounds，low blood loss and quick recovery，can further reduce serum AQP4 levels in patients with cerebral hemorrhage.

Key words: minimally invasive surgery, cerebral hemorrhage, safety, Cys-C, AQP4