Objective To explore the effects of blood conservation management on rapid rehabilitation in patients with total hip replacement. Methods A total of 120 patients who have undergone primary unilateral total hip replacement from November 2016 to June 2017 in the People's Hospital of Guangxi Zhuang Autonomous Region were selected and randomly divided into experimental group and control group, with 60 cases in each group. The patients in the control group were given hemostatic drugs and routine nursing care during perioperative period. The experimental group was treated with rapid rehabilitation nursing during perioperative period under blood protection management, including the protection of core body temperature, blood dilution, hemostatic, autotransfusion, controlled hypotension, iron drugs. The intraoperative blood transfusion rate, blood loss, postoperative drainage, the removal time of drainage tube and the average length of hospitalization were compared between two groups. Results The blood transfusion rate of the experimental group was 3.33%, and that of the control group was 26.67%, with statistical significance (χ2=12.810, P<0.01) . In the experimental group, the amount of intraoperative blood loss was (240.86±65.78) ml, postoperative drainage (433.95±72.26) ml, the removal time of drainage tube was (36.2±6.5) h and the average hospitalization day was (6.9±2.1) , which were all lower than those of the control group [ (320.32±70.48) ml, (511.71±85.66) ml, (50.4±2.8) h, (8.1±3.4) d], and the differences were statistically significant (t=-3.659, 3.800, -2.860, 3.800; P<0.01) . Conclusions The application of rapid rehabilitation surgery blood protection management in patients with total hip replacement during the perioperative period is significant, which is beneficial to the early rehabilitation of patients, and opens a new concept for the rapid rehabilitation of joint replacement surgery. Key words: Arthroplasty, replacement, hip; Perioperative nursing; Rapid rehabilitation surgery; Blood management