中国耳鼻咽喉颅底外科杂志2026，Vol.32Issue(4)：111-115,5.DOI:10.11798/j.issn.1007-1520.202625366
鼻内镜手术围手术期低血压的危险因素及多学科综合管理
Perioperative hypotension in endoscopic sinus surgery:Risk factors and multidisciplinary management
摘要
Abstract
Perioperative hypotension is a common clinical complication in endoscopic sinus surgery(ESS).Its occurrence is arising from the complex interplay of surgical manipulation,anesthetic management,and local medication administration.Based on a literature review,this narrative review aims to summarize the risk factors and mechanisms of perioperative hypotension,as well as management strategies in ESS.The main risk factors include surgical triggers such as the TCR(Trigeminocardiac Reflex),systemic absorption of topical epinephrine leading to β2-receptor-mediated rebound hypotension,the effects of anesthetic agents(e.g.,the vasodilatory effect of propofol,high-dose remifentanil),and patient-related factors(e.g.,older age,comorbid cardiovascular diseases).Management strategies emphasize multidisciplinary collaboration,encompassing preoperative risk assessment and circulatory optimization,intraoperative dynamic monitoring with stepwise pharmacological intervention,and rigorous postoperative observation.The implementation of comprehensive management strategies can effectively reduce the risk of hypotension.Future efforts should focus on developing risk prediction models based on the Chinese population and exploring alternative approaches such as novel hemostatic materials and the integration of traditional Chinese and Western medicine.关键词
鼻内镜手术/低血压/肾上腺素/围手术期管理Key words
Endoscopic sinus surgery/Hypotension/Epinephrine/Perioperative management分类
医药卫生引用本文复制引用
李艳丽,王迎斌,徐百成,李勇..鼻内镜手术围手术期低血压的危险因素及多学科综合管理[J].中国耳鼻咽喉颅底外科杂志,2026,32(4):111-115,5.基金项目
甘肃省自然科学基金项目(24JRRA1106). （24JRRA1106）
