随着全球人口老龄化加剧，骨关节炎等关节疾病患病率显著攀升，髋膝关节置换手术需求也随之增加。然而，手术效果受患者基础疾病（如高血压、糖尿病）、手术技术及假体选择等多因素影响，尤其是老年患者合并症复杂，进一步增加了手术风险与难度。术中及术后出血是髋膝关节置换术的重要挑战。老年及合并症患者常面临隐性失血与输血需求增加，易引发感染、输血反应等并发症。尽管现有指南关注围手术期血液管理，但术中止血的具体策略仍缺乏系统指导。因此，迫切需要深入研究与发展术中规范的止血操作，以减少出血量，降低输血相关风险，优化血液资源利用，促进患者术后康复，并缓解医疗系统压力。为此，共识专家组基于证据分级与专家讨论形成推荐意见，为手术止血提供标准化参考框架。共识强调临床实施需结合个体化评估，根据临床实际灵活应用。

With the accelerating global population aging, the prevalence of joint diseases such as osteoarthritis has risen markedly, driving an increasing demand for hip and knee arthroplasty. However, surgical outcomes are influenced by multiple factors, including underlying comorbidities of patients (e.g., hypertension and diabetes), surgical techniques, and prosthesis selection. The complexity of comorbidities in elderly patients further amplifies surgical risks and technical challenges. Intraoperative and postoperative hemorrhage remains a pivotal challenge in hip and knee arthroplasty. Elderly patients and those with comorbidities often experience hidden blood loss and elevated transfusion requirements, predisposing them to complications such as infections and transfusion-related adverse events. Although existing guidelines emphasize perioperative blood management, systematic guidance on intraoperative hemostatic strategies remains insufficient. Therefore, there is an urgent need to advance research and standardize intraoperative hemostatic protocols to reduce blood loss,minimize transfusion-associated risks, optimize blood resource utilization, enhance postoperative recovery, and alleviate healthcare system burdens. To address these issues, the consensus expert panel formulated evidencebased recommendations through evidence grading and multidisciplinary discussions, establishing a standardized reference framework for surgical hemostasis. This consensus underscores the necessity of individualized clinical implementation, advocating flexible adaptation based on real-world practice.