目的　探讨控制性降压结合急性高容血液稀释 (AHH)用于鼻内窥镜手术的安全性及其对减少出血量和缩短手术时间的效果。方法　择期行鼻内窥镜手术病人 2 0例 ,随机分成对照组 (I组 ,n =10 )和降压组 (II组 ,n =10 ) ,两组病人均采用气管内全麻。II组病人于气管插管后手术开始前完成血液稀释并进行控制性降压。比较两组病人手术时间 ,术中出血量 ,术后Hb、Hct以及围术期血液动力学变化。结果　II组病人手术时间较I组缩短 44 % ,术中平均出血量为 ( 97± 14 )ml,明显少于I组 ( 4 86± 42 )ml(P <0 0 1) ;I组 2例病人输血 2 0 0ml ,II组所有病人避免输血 ;两组病人手术开始后 60min及术毕Hb、Hct均明显低于术前 (P <0 0 1) ,II组与I组同期比较明显降低 (P <0 0 5 ) ,而术后第 1d两组比较无明显差异。围术期两组病人Hb、Hct均在安全范围内 ;围术期血液动力学平稳。结论　控制性降压结合急性高容血液稀释可安全应用于鼻内窥镜手术 ,并能减少术中出血量 ,缩短手术时间。 Objective To investigate the safety of controlled hypotension combined with acute hypervolemic hemodilution (AHH) for nasal endoscopic surgery and its effect on reducing the amount of bleeding and shortening the operation time. Methods Twenty patients undergoing endoscopic sinus surgery were randomly divided into control group (group I, n = 10) and antihypertensive group (group II, n = 10). All patients underwent endotracheal anesthesia. Patients in Group II completed hemodilution and controlled hypotension prior to the beginning of endotracheal intubation surgery. The operation time, intraoperative blood loss, postoperative Hb, Hct and perioperative hemodynamic changes were compared between the two groups. Results The operation time of Group II was 44% shorter than that of Group I, and the average amount of bleeding during operation was (97 ± 14) ml, which was significantly lower than that of Group I (4 86 ± 42) ml (P <0.01) Patients were transfused 200 ml, and all patients in group II were prevented from transfusing blood. The Hb and Hct of Hb and Hct in both groups were significantly lower than those before operation (P <0.01) P <0 05), but there was no significant difference between the two groups on the 1st postoperative day. Perioperative patients Hb, Hct two groups are in the safe range; perioperative hemodynamics stable. Conclusion Controlled antihypertensive combined with acute hypervolemic hemodilution can be safely applied to endoscopic sinus surgery and can reduce intraoperative blood loss and shorten the operation time.