功能性鼻内镜手术中减少出血的麻醉管理研究进展

功能性鼻内镜手术(FESS)已被广泛应用于鼻窦炎和鼻息肉患者的临床治疗。外科医师必须依赖最佳的手术视野来确认解剖位置，但鼻腔空间狭小，即使是少量出血也会造成解剖结构难以辨别，导致手术时间延长，手术并发症的发生率增加。目前，鼻内镜手术出血原因主要包括3个方面，即手术因素、患者自身因素以及麻醉因素。本文从麻醉方式、机械通气、术中控制性降压、围术期用药等方面对能够减少鼻内镜手术中出血的麻醉技术进行综述，以期为该类手术的麻醉管理提供参考。

Research progress of anesthesia management for reducing intraoperative bleeding in functional endoscopic sinus surgery

Functional endoscopic sinus surgery (FESS) has been widely used in the clinical treatment of patients with sinusitis and nasal polyps. Surgeons must rely on the best operative field to confirm the anatomical position. Never the less for the narrow nasal space, even a small amount of bleeding can make it difficult to distinguish anatomical structures, resulting in prolonged operation time and increased incidence of surgical complications. The factors that cause bleeding in endoscopic sinus surgery mainly include three aspects: surgical factors, patient''s own factors, and anesthesia factors. This article reviewes the anesthesia techniques that can reduce bleeding in nasal endoscopic surgery, from the aspects of anesthesia methods, mechanical ventilation, intraoperative controlled blood pressure, and perioperative medication, in order to provide a reference to the anesthesia management of such procedures.