目的总结早期手术治疗急性破裂出血颅内动脉瘤的经验。方法29例患者72h内手术,2例患者6h内手术,均采用显微神经外科技术。结果瘤颈夹闭29例,瘤颈夹闭十包裹1例,1例大脑中动脉M3远端动脉瘤急诊手术术中破裂行载瘤动脉夹闭,出院时优20例,良6例,差4例,死亡1例。结论早期显微手术为治疗动脉瘤的有效方法,能减少血管痉挛,提高治愈率。 Objective To summarize the experience of early surgical treatment of acute rupture of intracranial aneurysms. Methods Twenty-nine patients underwent surgery within 72 hours and two patients underwent surgery within 6 hours. All patients underwent microsurgical neurosurgery. Results Tumor embolization in 29 cases, aneurysm closure in 10 cases in 1 case, 1 case of middle cerebral artery M3 distal aneurysm in the operation of emergency rupture of the parent artery occlusion, discharge was excellent in 20 cases, good in 6 cases, poor 4 cases, 1 died. Conclusion Early microsurgery is an effective method for the treatment of aneurysms, which can reduce vasospasm and improve the cure rate.