To explore the influence of intraoperative intravenous tranexamic acid(TXA) on the recessive blood loss of the first unilateral total hip arthroplasty (THA) to further guide clinical work.

From December 2013 to June 2015, 52 patients who were diagnosed as osteonecrosis of the femoral(ONFN)、 osteoarthritis(OA)、 development dysplasia of the hip (DDH)、 femoral neck fracture and underwent the first unilateral THA in the first hospital affiliated to Sun Yat-sen University were retrospectively screened, compared and analyzed. The patients who underwent bilateral THA, allergic to TXA, and coagulation dysfunction were excluded. Among them, TXA was used intravenously in the experimental group, while TXA was not used intravenously in the control group. Each group were 26 cases. The independent sample t test was used to compared total blood loss, dominant blood loss and recessive blood loss during the perioperative period.The chi-square test was used to compare gender, involved side and basic diseases.

The total blood loss during the perioperative period of the experimental group was lower than that of the control group, and the difference was statistically significant[(905±348)ml vs(1 113±389)ml, t=2.037, P<0.05]. The amount of recessive blood loss in the experimental group was also lower than that in the control group, and the difference was statistically significant[(261±252)ml vs(429±399)ml, t=2.027, P<0.05]. The dominant blood loss in the experimental group was similar to that in the control group, and the difference was not statistically significant[(643±313)ml vs(684±237)ml, P>0.05]. There was also no significant difference in gender, age, preoperative albumin, blood coagulation indexes between the two groups(P>0.05). In addition, the total amount of blood loss during perioperative period was positively correlated with the amount of recessive blood loss after combining the two groups of data, with a correlation coefficient of 0.698.

Intraoperative intravenous use of TXA in patients with the first unilateral THA can safely and effectively reduce total blood loss and recessive blood loss, but the impact on dominant blood loss needs further study.