目的:探讨血清核转录因子kappaB(NF-кB)、透明质酸(HA)水平对急性自发性脑出血(sICH)患者小骨瓣开窗血肿清除术后转归的预测价值。方法:抽取2018年10月至2020年2月于南阳南石医院接受小骨瓣开窗血肿清除术治疗的79例sICH患者为研究对象，术后3个月时采用改良Rankin评分量表(mRS)评估患者预后并分组；设计一般资料调查问卷，询问患者基线资料，记录并比较两组基线资料，检测并比较两组血清NF-кB、HA水平，分析血清NF-кB、HA水平预测sICH患者小骨瓣开窗血肿清除术后预后不良风险价值。结果:79例sICH患者小骨瓣开窗血肿清除术后21例(26.58%)预后不良；预后不良组NF-кB、HA水平均高于预后良好组，差异有统计学意义(n P0.05)；经单因素分析后建立多元回归模型行多因素分析结果显示，NF-кB、HA过表达均是sICH患者小骨瓣开窗血肿清除术后预后不良的影响因素(n OR>1，n P1,n P<0.05); the receiver opeating characteristic (ROC) curve was drawn, the result showed that when the cut-off values of serum NF-кB and HA were 0.265 mmol/L and 324.300 ng/ml, respectively, the best predictive value of the risk of poor prognosis after fenestration of sICH patients could be obtained. When the area under the ROC curve (AUC) were 0.874 and 0.878, there was a certain predictive value.n Conclusions:There is a risk of poor prognosis after small bone flap fenestration hematoma evacuation in sICH patients, which may be related to the overexpression of serum NF-кB and HA. In the future, the detection of serum NF-кB and HA levels can be considered to guide early risk assessment of poor prognosis, which may be of positive significance for early reasonable intervention and improving the prognosis of sICH patients.