Application effect of tranexamic acid combined with liposomal bupivacaine in hip arthroplasty

ZHANG Jin-ling; DAI Zhen; ZHOU Jian; RONG Gen-xiang; TANG Zhi; NI Meng; FENG Cheng-cheng; GUI Bin-jie

doi:10.11659/jjssx.09E025066

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Application effect of tranexamic acid combined with liposomal bupivacaine in hip arthroplasty

Minimally Invasive Orthopedic Techniques and Perioperative Safety | 更新时间：2026-07-24

- Application effect of tranexamic acid combined with liposomal bupivacaine in hip arthroplasty
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 7, Pages: 579-583(2026)
- 作者机构：
  
  安徽医科大学第一附属医院骨科，安徽合肥 230022
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.09E025066
  CLC： R687.4
- Received：17 September 2025，
  
  Online First：24 July 2026，
  
  Published：25 July 2026
- 稿件说明：
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张金陵,戴臻,周剑等.氨甲环酸联合布比卡因脂质体在髋关节置换术中的应用效果[J].局解手术学杂志,2026,35(07):579-583.

ZHANG Jin-ling,DAI Zhen,ZHOU Jian,et al.Application effect of tranexamic acid combined with liposomal bupivacaine in hip arthroplasty[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(07):579-583.
张金陵,戴臻,周剑等.氨甲环酸联合布比卡因脂质体在髋关节置换术中的应用效果[J].局解手术学杂志,2026,35(07):579-583. DOI： 10.11659/jjssx.09E025066.

ZHANG Jin-ling,DAI Zhen,ZHOU Jian,et al.Application effect of tranexamic acid combined with liposomal bupivacaine in hip arthroplasty[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(07):579-583. DOI： 10.11659/jjssx.09E025066.

摘要

目的

探讨氨甲环酸联合布比卡因脂质体对髋关节置换术后患者镇痛效果、凝血功能及失血的影响。

方法

选择2024年10月至2025年4月我院拟行髋关节置换术的患者，随机分为对照组和观察组，每组50例。对照组患者给予罗哌卡因切口封闭，观察组患者给与布比卡因脂质体加氨甲环酸关节腔灌注。比较2组患者的手术指标、镇痛效果、纤溶及炎症指标[D-二聚体、C反应蛋白（CRP）、白细胞介素-6（IL-6）]、凝血功能[活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）、凝血酶时间（TT）和纤维蛋白原（FIB）]和蒙特利尔认知评估量表（MoCA）评分。

结果

观察组患者术中出血量低于对照组，术后首次下床时间短于对照组，差异均有统计学意义（

0.05）。术后48 h内，观察组患者视觉模拟评分法（VAS）评分低于对照组，术后24 h观察组MoCA评分高于对照组，差异均有统计学意义（

0.05）。术后观察组患者D-二聚体、CRP、IL-6水平低于对照组，APTT、PT、TT短于对照组，FIB水平高于对照组，差异均有统计学意义（

0.05）。

结论

氨甲环酸联合布比卡因脂质体用于髋关节置换术可有效减少患者术中出血量，显著提升术后短期镇痛效果，降低纤溶活性，减轻炎症反应，优化凝血功能，对术后早期认知功能恢复有积极作用，是一种安全、有效的围术期管理方案。

Abstract

Objective

To investigate the effects of tranexamic acid combined with liposomal bupivacaine on analgesic effect， coagulation function， and blood loss in patients after hip arthroplasty.

Methods

Patients scheduled for hip arthroplasty at our hospital from October 2024 to April 2025 were randomly divided into the control group and the observation group， with 50 cases in each group. The control group received ropivacaine for incision closure， and the observation group received liposomal bupivacaine plus tranexamic acid for intra-articular instillation. The surgical indicators，analgesic effects，fibrinolytic and inflammatory indicators ［D-dimer，C-reactive protein（CRP），interleukin-6（IL-6）］，coagulation function ［（activated partial thromboplastin time， APTT），（prothrombin time， PT），（thrombin time， TT），（fibrinogen， FIB）］，and Montreal cognitive assessment （MoCA） scores were compared between two groups.

Results

The observation group had lower intraoperative blood loss and shorter time to first ambulation after surgery than the control group， with statistically significant differences （

0.05）. The observation group had significantly lower visual analogue scale （VAS） scores within 48 hours postoperatively and significantly higher MoCA scores 24 hours after surgery compared with the control group， with statistically significant differences （

0.05）. The observation group had lower levels of D-dimer，CRP，IL-6， shorter APTT，PT，and TT，and a higher level of FIB compared with the control group， with statisticall

y significant differences（

0.05）.

Conclusion

The combination of tranexamic acid and liposomal bupivacaine in hip arthroplasty effectively reduces intraoperative blood loss， significantly improves short‑term postoperative analgesia effect， reduces fibrinolytic activity， alleviates inflammatory responses， optimizes coagulation function， and has positive effect on early postoperative cognitive recovery. It is a safe and effective perioperative management strategy.

关键词

Keywords

references

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