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目的:比较不同水平控制性低血压在鼻窦镜手术中的应用效果及安全性。方法:选取2016年3月至2018年2月在连州市人民医院行慢性鼻窦炎鼻窦开放手术的患者90例，采用随机数字表法分成三组，每组30例，对三组患者术中实施控制性降血压，以入院至手术前1 d的平均动脉压值作为基础血压，术中血压控制性降低20% （A组）、控制性降低35%（B组）、控制性降低50%（C组）。三组手术方式及手术人员相同。比较三组术中术野清晰情况、出血量、血气分析及生命体征变化情况、总手术时间、苏醒时间、拔管时间、术者对手术环境的满意程度、住院时间。结果:三组均顺利完成手术，三组的血气分析各主要参数、苏醒时间、拔管时间等均差异无统计学意义（n t=1.863、1.772、1.513、1.221、1.376、1.512，均n P>0.05）；C组术野清晰情况最优，术者对手术环境的满意程度最高，满意度为93.33%（28/30），明显高于A组的53.33%（16/30）和B组的70.00%（21/30）（χn 2=8.226，n P<0.01；χn 2=4.136，n P<0.05）；C组出血量最少［（56±18）mL］，与B组和A组比较，均差异有统计学意义（n t=3.863、9.102，均n P<0.05、n P<0.01）；C组总手术时间最短［（58±11）min］，与B组及A组比较，均差异有统计学意义（n t=3.025、7.983，n P<0.05、n P 0.05). The operation field in the group C was the most optimal, and patient satisfaction to operation environment in the group C [93.33% (28/30)] was significantly higher than that in the group A [53.33% (16/30)] and group B [70.00% (21/30)] (χn 2= 8.226, n P < 0.01; χ n 2= 4.136, n P < 0.05). The amount of blood loss in the group C [(56 ± 18) mL] was the lowest,and it was significantly lower than that in the groups B and A ( n t = 3.863, 9.102, n P < 0.05, n P < 0.01). The operation time in the group C was the shortest [(58 ± 11) min], and it was significantly shorter than that in the groups B and A (n t = 3.025, 7.983, n P < 0.05, n P < 0.01).n Conclusion:Controlled hypotension in endoscopic sinus surgery is safe and necessary, and controlling blood pressure to 50% of basic blood pressure is more conducive to providing a clear surgical field to facilitate operation, thereby improving therapeutic efficacy.