目的 探究影响骨科手术术后康复的因素，并依据影响因素提出可采取的药学干预策略及用药合理性分析。方法 选取2019年1月1日—2020年12月31日于开滦总医院进行骨科手术的住院患者为研究对象，收集患者基本信息、手术相关信息以及围术期应用药物相关信息。采用单因素、多因素Logistic回归对住院时长、术后24 h视觉模拟（VAS）评分、出院时VAS评分、3个月复诊时VAS评分以及住院期间恶心呕吐发生率进行分析，建立影响因素的预测模型并验证。结果 共收集到9 258例患者信息，性别、年龄、手术类别、麻醉类别及术后镇静药物均可影响骨科术后患者的康复情况；其中，女性、应用静吸复合麻醉、单用吗啡类镇痛药及围术期使用抗菌药物可增加术后恶心呕吐的概率。结论 老年女性患者在骨科术后康复的过程中应给予更多的关注，静脉麻醉及术后应用吗啡联合非甾体抗炎药镇痛可改善预后。

Objective To explore the factors affecting the rehabilitation after orthopedic surgery, and put forward the pharmaceutical intervention strategies and drug rationality analysis according to the influencing factors. Methods The inpatients who underwent orthopaedic surgery in Kailuan General Hospital from January 1, 2019 to December 31, 2020 were selected as the research object, and the basic information, operation related information and perioperative drug related information were collected. Univariate and multivariate logistic regression were used to analyze the length of stay, 24 h visual analog score (VAS), VAS score at discharge, VAS score at three months follow-up and the incidence of nausea and vomiting during hospitalization. The prediction model of influencing factors was established and verified. Results A total of 9 258 patients were collected. Gender, age, operation type, anesthesia type and postoperative sedative drugs could affect the rehabilitation of orthopaedic patients. Among them, women, combined intravenous and inhalation anesthesia, opioid analgesics alone and perioperative use of antibiotics can increase the probability of postoperative nausea and vomiting. Conclusion More attention should be paid to the elderly female patients in the process of postoperative rehabilitation. Intravenous anesthesia and postoperative analgesia with opioids combined with non steroidal anti-inflammatory drugs can improve the prognosis.

R969.4

邢台市重点研发计划自筹基金项目(2020ZC279)