Abstract:

Objective To explore the effect of pulse irrigation combined with tranexamic acid on periopera⁃tive blood loss，coagulation function and hip joint functionin elderly patients with intertrochanteric fracture undergo⁃ing artificial femoral head replacement. Methods A retrospective study was performed in 67 patients with intertro⁃chanteric fracture undergoing artificial femoral head replacement. The patients were randomly divided into threegroups before surgery. Tranexamic acid was diluted by 20 mg/kg to 250 mL is osmotic saline one hour before surgery.In group A，patients received 200ml intravenous drip，intraoperative routine irrigation，and 50 mL tranexamic acidsolution was injected into hip cavity after skin suture. In group B，pulse irrigation was changed intraoperatively. Ingroup C，routine intraoperative irrigation was performed without tranexamic acid. Blood loss，postoperative coagula⁃tion function and hip function of the three groups were compared. Results There was no difference in the dominantblood loss between group A and C（P > 0.05），and the dominant blood loss in group B was less than that in group C（P < 0.05）. The total and hidden blood loss of group A and B were less than that of group C（P < 0.05），and that ofgroup B was less than that of group A（P < 0.05）. Blood coagulation was increased in group A when compared withthat in group C（P < 0.05），while it was not increased in group B（P > 0.05）. Harris score of hip joint in group A andGroup B was higher than that in group C one month after surgery（P < 0.05），and the score in group B was higherthan that in group A（P < 0.05）. Conclusion In elderly patients with intertrochanteric fractures，pulse irrigationcombined with tranexamic acid during artificial femoral head replacement can significantly reduce perioperativeblood loss without increasing blood clotting，which is conducive to the early and rapid recovery of the patients.

Key words: pulse irrigation, tranexamic acid, intertrochanteric fracture, artificial femoral head