Abstract: Objective：To investigate the effect of different administration routes of tranexamic acid on inflammatory factors and safety during total hip arthroplasty.Methods：The clinical data of 79 patients undergoing total hip arthroplasty in our hospital from February 2017 to July 2020 were retrospectively analyzed.Among them,41 cases were treated with tranexamic acid intra articular cavity local powder(group A),and 38 cases were treated with tranexamic acid intravenous drip(group B).The perioperative blood loss [intraoperative blood loss,postoperative drainage volume,total blood loss,hemoglobin(HB) and hematocrit(Hct) decreased value ] of the two groups were compared.The changes of fibrinolytic index and inflammatory index were compared between the two groups.The incidence of complications was compared between the two groups.Results：There was no significant difference in the amount of intraoperative blood loss between group A and group B(P>0.05).The postoperative drainage volume,total blood loss,Hb and HCT decreased value in group A were less than those in group B(P<0.05).Plasma fibrinogen(Fg),fibrinogen degradation product(FDP),and Ddimer(DD) levels after surgery in the two groups were higher than those before surgery(P＜0.05).There was no statistically significant difference in plasma Fg,FDP,DD before and after operation between the two groups(P>0.05).The levels of serum Creactive protein(CRP) and tumor necrosis factorα(TNFα) in the two groups were higher than those before operation(P＜0.05).There was no significant difference in serum CRP and TNFα levels before and after operation between the two groups(P>0.05).There was no significant difference in the incidence of deep vein thrombosis,incision infection and total incidence of complications between the two groups(P>0.05).Conclusion：The application of topical powder during total hip replacement surgery can reduce hidden blood loss compared with intravenous administration.The two methods of administration have the same effect on the level of inflammatory factors and their safety.

Key words: total hip replacement, tranexamic acid, Creactive protein, tumor necrosis factorα