To explore effect of tranexamic acid injection in femoral bone marrow cavity on perioperative blood loss in patients with femoral intertrochanteric fracture.

108 patients of intertrochanteric fracture admitted to our hospital were selected, they were divided into control group (n=54) and observation group (n=54) according to the random number table method. TXA was infused into the veins of the control group before the reaming, and the observation group was injected with TXA in the medullary cavity after the operation. Intraoperative blood transfusion volume, blood transfusion rate in the two groups were compared; The recessive, dominant and perioperative total blood loss in the two groups were compared; The coagulation indexes were compared before and 5 days after operation in the two groups; the drainage volume at 24 hours after operation was compared in the two groups, both groups were followed up for 2-6 months, the incidence of complications such as deep vein thrombosis and pulmonary embolism in the two groups during the follow-up period was calculated.

In the observation group, the intraoperative blood transfusion volume, blood transfusion rate, 24 hours postoperative blood flow, recessive, dominant and perioperative total blood loss[(0.31±0.09)U, 11.11%, (198±101)ml, (528±157)ml, (375±103)ml, (892±232)ml] were less than those in the control group [(0.49±0.13)U, 29.63%、(495±123)ml, (843±237)ml, (469±144)ml, (1309±372)ml](P<0.05). Compared with before surgery, 5 days after surgery, the APTT levels in the two groups increased, and the APTT level in the observation group[(32.64±5.96) s] was lower than that in the control group [(37.52±6.17) s](P<0.05); the PT level of the control group [(12.87±2.32) s] on day 5 after the operation was higher than that before the operation [(15.49±2.82) s], and the observation group [(12.87±2.32) s] was significantly lower than the control group (P<0.05), there was no significant difference in INR between the two groups before and 3 days after the operation (P>0.05). During follow-up, there was no significant difference in the incidence of deep vein thrombosis of the lower extremities between the two groups after operation (P>0.05), and no pulmonary embolism occurred.

Femoral medullary injection of TXA can effectively reduce perioperative blood loss in patients with intertrochanteric fractures during PFNA internal fixation, increasing hemoglobin and hematocrit levels, reducing invisible blood loss, without increasing the risk of deep vein thrombosis and pulmonary embolism after surgery.