Objective To explore the effectiveness and safety of the application of comprehensive interventions in reducing perioperative bleeding during artificial total knee arthroplasty. Methods 117 cases were selected in our hospital from January 2015 to December 2017 for artificial total knee surface replacement, and routine methods and comprehensive intervention measures were used to reduce perioperative bleeding. There were 52 males and 65 females; the age was 56-79 years, with an average of (64.79±4.46) years; the average BMI was (31.83±1.70) Kg/m2; 51 cases were left knee and 56 cases were right knee. Unilateral total knee arthroplasty was performed under general anesthesia, and tourniquets were used throughout the operation. After the prosthesis is installed, the tourniquet is loosened to completely stop the bleeding, and the subcutaneous and posterior joint capsule injections are performed respectively by the cocktail method, and a negative pressure drainage tube is placed in the incision for drainage. In the conventional hemostasis group, the postoperative drainage tube was drained with normal negative pressure, and the comprehensive intervention group received an intravenous infusion of 1.5 g of tranexamic acid 30 minutes before the intraoperative tourniquet loosening on the basis of conventional hemostasis treatment, and another intravenous infusion 2 hours after the operation. Tranexamic acid 1.5g was injected, and the drainage tube was clamped within 6 hours after surgery. The drainage tube was not drained under negative pressure within 6 to 12 hours after surgery, and drained under normal negative pressure after 12 hours. The drainage tube was removed 48 hours after the operation in both groups; low molecular weight heparin was injected subcutaneously 12 hours after the operation for one week. After discharge, the patients were switched to oral rivaroxaban to continue anticoagulation treatment. Observe and compare the clinical results and complications of the two groups. Results There was no statistical difference between the two groups in terms of incision length, operation time, and intraoperative blood loss (P>0.05). However, there were statistical differences in the amount of postoperative drainage fluid between the two groups. The comprehensive intervention group was less than conventional hemostasis. group. On the third day after surgery, the knee pain VAS score, the comprehensive intervention group had less pain, and the contrast was statistically different (P<0.05). No deep venous thrombosis of the lower extremities was found before operation in both groups. On the 5th day after the operation, there were 5 cases of intermuscular venous thrombosis in the routine hemostasis group, the incidence rate was 8.93%; the comprehensive intervention group had 7 cases of intermuscular venous thrombosis, the incidence rate was 11.48%, there was no statistically significant difference between the two groups (P>0.05). There was no blood transfusion in the comprehensive intervention group. 16 cases in the conventional hemostasis group received allogeneic blood transfusion after surgery. The blood transfusion rate was 28.6%, and the average blood transfusion was (320±45.8) ml. There was a statistical difference between the two groups (P<0.05). There were statistical differences between the two groups in hemoglobin and hematocrit on the first, third and seventh days after surgery (P<0.05). The comprehensive intervention group was better than the conventional hemostasis group. Postoperative skin ecchymosis of the affected limb: 19 cases occurred in the conventional hemostasis group and 23 cases in the comprehensive intervention group. There was no statistical difference between the two groups (P>0.05). There were no incision skin necrosis and infection in both groups. The patients in the two groups were followed up for 6 to 36 months with an average of (20.5±8.24) months. HSS score: The HSS score of the conventional hemostasis group ranges from the average preoperative (59.94±6.34) points to the average (82.86±7.81) points at the last follow-up, which is statistically significant (P<0.05) compared with the preoperative comparison; the comprehensive intervention group The HSS score ranged from the preoperative average (60.25±6.79) points to the final follow-up average (84.12±8.05) points, and the difference was statistically significant (P<0.05). There was no statistically significant difference in HSS scores between the two groups before surgery or at the final follow-up (P>0.05). Conclusion The comprehensive measures such as the sequential use of tranexamic acid combined with intermittent drainage of the incision significantly reduce the bleeding during the perioperative period of artificial total knee arthroplasty, reduce the rate of allogeneic blood transfusion, relieve the tension of blood source, and improve the operation It is safe, promotes the recovery of patients, has good clinical application value, and is worthy of reference.