OBJECTIVE： To observe the effects of different routes of administration of tranexamic acid on coagulation function and amount of bleeding in patients with one stage posterior surgery of thoracic tuberculosis. METHODS： 40 patients suffered from thoracic tuberculosis in our hospital from Jan. 2011 to Dec. 2013 were randomly divided into intravenous group （5％ Glucose injection 100 ml+tranexamic acid 10 mg/kg， through an intravenous drip at 30 min before closing the wound） and topical application group （5％ Glucose injection 10 ml and tranexamic acid 10 mg/kg， through soaking the wound before closing the wound） with 20 cases in each group. Other 15 cases suffered from the thoracic tuberculosis in our hospital from Jan. 2009 to Dec. 2010 were included in control group. 3 groups received one stage posterior surgery of thoracic tuberculosis， interbody fusion and internal fixation. The difference of hemoglobin， coagulation function and the amount of suction drainage were observed before and after surgery， and followed up. Bone graft fusion and therapeutic condition of tuberculosis were observed in the study. RESULTS： There was no statistical significance in postoperative suction drainage between intravenous group and topical application group （P＞0.05）， but their decrease was more significant than control group， with statistical significance （P＜0.05）. There was no statistically difference in fiber protease， prothrombin time or activated partial thromboplastin time among 3 groups （P＞0.05）. The difference value of hemoglobin in control group before and after operation was significantly higher than in intravenous group and topical application group， with statistical significance （P＜0.05）； there was no statistical significance between intravenous group and topical application group （P＞0.05）. 55 patients were all followed up and bone graft of all cases were fused， and all patients were cured and no case recurred. CONCLUSIONS： Tranexamic acid by intravenous application or topical application can reduce hemorrhage and anemia after operation of thoracic tuberculosis， and has no effect on blood coagulative system.