Objective:To explore the efficacy and safety of combined application of Tranexamic Acid and three-dimentional-printed navigation template in reducing the blood loss of primary unilateral total knee arthroplasty.Method:A total of 60 patients who received primary unilateral total knee arthroplasty in Orthopedics Hospital of Shenyang City from December 2013 to November 2015,were divided into the experiment group(30 cases) and the control group(30 cases).Patients in the experiment group received three-dimentional-printed navigation template and Tranexamic Acid Injection with clamping the drainage tube for 3 hours,patients in the control group received the same volume of physiological saline injection and the drainage tube maintained open,the drainage tubes in all patients were removed 48 hours after surgery.Result:There were no significant differences in age,gender,left or right side,BMI,ASA score,PT,APTT,FIB,hemoglobin level and HCT before surgery between two groups(P>0.05).There were significant differences in hemoglobin level and HCT 1 day and 3 days after surgery between two groups(P<0.05).Duration of operation,postoperative total blood loss,postoperative suction drainage,the hidden blood loss and blood transfusion volume of patients in the experiment group were significantly less than those in the control group(P<0.05).Venous thrombosis was not found by deep vein colour duplex ultrasonography of both lower limbs 7 days after surgery.Conclusion:Combined application of three-dimentional-printed navigation template and intra-articular injection of Tranexamic Acid and clamping the drainage tube for 3 hours can reduce blood loss significantly after the primary unilateral total knee arthroplasty without increasing the occurrence of deep-vein thrombosis,the method is effective and safe.%目的：探讨3D打印导航模板膝关节置换术中使用氨甲环酸对减少初次单膝关节置换术患者失血量的有效性和安全性。方法：选取2013年12月-2015年11月本院行单侧初次全膝关节置换术共60例（60膝），将患者分为试验组与对照组，每组30例。试验组术中采用3D打印导航模板技术并予关节腔内注入氨甲环酸60 mL（0.6 g）且保持引流管关闭3 h，对照组未采用3D打印导航模板技术，术中关节腔内注射生理盐水60 mL，并保持引流管开放，两组引流管均于术后48 h拔除。结果：试验组与对照组患者年龄、性别、左/右侧、体重指数、ASA评分、PT、APTT、FIB、术前HGB和HCT水平比较，差异均无统计学意义（P>0.05）。术后1、3 d两组HGB和HCT比较，差异均有统计学意义（P<0.05）。试验组手术时间、术后总失血量、术后引流量、隐性失血量及输血量较对照组均明显减少，差异均有统计学意义（P<0.05）。术后第7天复查双下肢静脉彩超未发现深静脉血栓形成。结论：3D打印导航模板膝关节置换术中使用氨甲环酸关节腔内注射并维持引流管夹闭3 h，能有效减少初次单膝关节置换术后的失血量，且不增加下肢深静脉血栓等并发症的发生率，该方案安全、有效。
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