目的 探究影響骨科手術(shù)術(shù)后康復(fù)的因素，并依據(jù)影響因素提出可采取的藥學(xué)干預(yù)策略及用藥合理性分析。方法 選取2019年1月1日—2020年12月31日于開灤總醫(yī)院進(jìn)行骨科手術(shù)的住院患者為研究對(duì)象，收集患者基本信息、手術(shù)相關(guān)信息以及圍術(shù)期應(yīng)用藥物相關(guān)信息。采用單因素、多因素Logistic回歸對(duì)住院時(shí)長(zhǎng)、術(shù)后24 h視覺模擬（VAS）評(píng)分、出院時(shí)VAS評(píng)分、3個(gè)月復(fù)診時(shí)VAS評(píng)分以及住院期間惡心嘔吐發(fā)生率進(jìn)行分析，建立影響因素的預(yù)測(cè)模型并驗(yàn)證。結(jié)果 共收集到9 258例患者信息，性別、年齡、手術(shù)類別、麻醉類別及術(shù)后鎮(zhèn)靜藥物均可影響骨科術(shù)后患者的康復(fù)情況；其中，女性、應(yīng)用靜吸復(fù)合麻醉、單用嗎啡類鎮(zhèn)痛藥及圍術(shù)期使用抗菌藥物可增加術(shù)后惡心嘔吐的概率。結(jié)論 老年女性患者在骨科術(shù)后康復(fù)的過程中應(yīng)給予更多的關(guān)注，靜脈麻醉及術(shù)后應(yīng)用嗎啡聯(lián)合非甾體抗炎藥鎮(zhèn)痛可改善預(yù)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

邢臺(tái)市重點(diǎn)研發(fā)計(jì)劃自籌基金項(xiàng)目(2020ZC279)