目的 改进颅内动脉瘤手术入路,以最小的创伤来取得动脉瘤显微手术的最佳疗效。方法 根据颅内动脉瘤所在位置,精确设计“锁眼”手术入路,以2 cm左右直径的骨窗进行颅内动脉瘤夹闭等手术。32例手术中,眶上额下经眉弓入路28例,翼点入路1例,乳突后入路2例,额部中线旁入路1例。结果 32例患者35个动脉瘤,行32次“锁眼”显微手术,共有33个动脉瘤行夹闭术,其中3例为多发性动脉瘤,予一次手术夹闭,另行动脉瘤孤立术、包裹术各1例。所有手术无术后感染、出血及脑脊液漏等手术并发症。结论“锁眼”手术创伤小,疗效佳,外观影响少,费用节省,是动脉瘤有效和理想的显微手术入路。 Objective To improve the approach of intracranial aneurysm surgery and obtain the best effect of microsurgery for aneurysms with minimal trauma. Methods According to the location of intracranial aneurysms, the precise design of “keyhole” approach to surgery, with a diameter of about 2 cm bone window for intracranial aneurysm clipping surgery. Among the 32 cases, 28 cases were treated with supraorbital approach through the eyebrows, 1 case with pterional approach, 2 posterior approach to mastoid, and 1 parapleural approach. Results Thirty-two aneurysms were performed in 32 patients with “keyhole” microsurgery. A total of 33 aneurysms were occluded, of which 3 were multiple aneurysms. They were subjected to a surgical clipping and another aneurysm was isolated , Parcel surgery in 1 case. All surgery without postoperative infection, bleeding and cerebrospinal fluid leakage and other surgical complications. Conclusions The “keyhole” surgical trauma is small, the curative effect is good, the appearance is less affected, the cost is saved, which is an effective and ideal microsurgery approach for the aneurysm.