目的：研究在腰椎后路减压融合术（PLDF）围手术期如何降低隐性失血量，并探讨术前静脉应用氨甲环酸（TXA）是否有效。方法：采用前瞻性随机对照研究选取我院自2019年10月至2021年10月收治的110例因腰椎退行性疾病拟行PLDF手术治疗患者，将患者分为试验组（55例，术前30 min静脉滴注TXA 15 mg·kg^-1）和对照组（49例，术前30 min静脉滴注生理盐水作为安慰剂），对其进行记录并比较两组患者术后72 h理论总失血量（TBL）、隐性失血量（HBL）、视觉模拟评分法（VAS）评分、术前和术后（24、48、72 h）血红蛋白水平、D-二聚体、下肢深静脉血栓形成（DVT）等并发症发生情况，同时研究是否有其他并发症发生可能。结果：试验组患者术后72 h理论总失血量、隐性失血量、VAS评分均低于对照组，（459.54±100.28） ml vs.（572.63±109.77） ml、（194.79±44.58） ml vs.（274.36±54.38） ml、（5.831±0.769）分vs.（6.794±0.873）分，差异具有统计学意义（P<0.05）。试验组患者术后24 h血红蛋白水平高于对照组[（125.2±13.9） g·L^-1 vs.（117.7±12.2） g·L^-1]，差异具有统计学意义（P<0.05）。两组患者术后均无DVT及其他血栓事件发生。结论：术前静脉应用TXA不仅可有效减少PLDF围手术期隐性失血量，还可以缓解术后疼痛，且没有增加血栓事件的风险。

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