头颈癌术后留置气管套管患者症状群与前哨症状的调查研究  

Symptom clusters and sentinel symptoms in patients with indwelling tracheal cannula after head and neck cancer surgery

作　　者：赵瑞 徐晓霞 丁停停 孟金平 雷淼 Zhao Rui;Xu Xiaoxia;Ding Tingting;Meng Jinping;Lei Miao(Department of Nursing,Cancer Hospital Affiliated to Zhengzhou University(Henan Cancer Hospital),Zhengzhou 450008,China;Department of Head,Neck and Thyroid Surgery,Cancer Hospital Affiliated to Zhengzhou University(Henan Cancer Hospital),Zhengzhou 450008,China)

机构地区：[1]郑州大学附属肿瘤医院(河南省肿瘤医院)护理部,郑州450008 [2]郑州大学附属肿瘤医院(河南省肿瘤医院)头颈甲状腺外科,郑州450008

出　　处：《中华现代护理杂志》2023年第7期905-909,共5页Chinese Journal of Modern Nursing

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200157)。

摘　　要：目的了解头颈癌术后留置气管套管患者症状群,识别不同症状群的前哨症状。方法采用便利抽样法,选取2020年6月—2021年12月于郑州大学附属肿瘤医院(河南省肿瘤医院)头颈甲状腺外科住院行手术治疗的197例头颈癌患者为研究对象,于术后第7天采用一般资料问卷、安德森症状评估量表-头颈部进行问卷调查,应用探索性因子分析提取症状群,采用Apriori关联分析法识别症状群内的前哨症状。结果头颈癌术后留置气管套管患者存在4个症状群,分别为头颈癌-特异性症状群、疼痛-消化道症状群、发声/吞咽障碍症状群和疲乏-睡眠-情绪症状群,口腔和咽喉黏液是头颈癌-特异性症状群的前哨症状,恶心是疼痛-消化道症状群的前哨症状,麻木和针刺感是发声/吞咽障碍症状群前哨症状,悲伤难过是疲乏-睡眠-情绪症状群的前哨症状。结论头颈癌术后留置气管套管患者存在症状较多,组合成症状群,且各症状群内存在前哨症状,提示医务工作者应该将前哨症状作为症状群管理的切入点,以达到有效管理症状的目的。Objective To understand the symptom clusters of patients with indwelling tracheal cannula after head and neck cancer surgery,and to identify the sentinel symptoms of different symptom clusters.Methods A total of 197 patients with head and neck cancer who underwent surgical treatment in Department of Head,Neck and Thyroid Surgery in Cancer Hospital Affiliated to Zhengzhou University(Henan Cancer Hospital)from June 2020 to December 2021 were selected as the research objects by the convenient sampling method.On the 7th day after surgery,general information questionnaire and Anderson Symptom Inventory,Head and Neck Module were used,and exploratory factor analysis was used to extract symptom clusters.Apriori association analysis was used to identify sentinel symptoms in the symptom clusters.Results There were 4 symptom clusters in patients with indwelling tracheal cannula after head and neck cancer surgery,including head and neck cancer-specific symptom cluster,pain-digestive tract symptom cluster,voice/swallowing disorder symptom cluster and fatigue-sleep-emotional symptom cluster.Oral and throat mucus was the sentinel symptom of head and neck cancer-specific symptom cluster,nausea was the sentinel symptom of pain-digestive tract symptom cluster,numbness and needling sensation were the sentinel symptom of voice/swallowing disorder symptom cluster,sadness was the sentinel symptom of fatigue-sleep-emotional symptom cluster.Conclusions Patients with indwelling tracheal cannula after head and neck cancer surgery have more symptoms,which are combined into symptom clusters,and sentinel symptoms exist in each symptom cluster,suggesting that medical workers should take sentinel symptoms as the entry point for symptom cluster management to achieve effective management of symptoms.

关 键 词：头颈部肿瘤 气管套管 症状群 前哨症状 

分 类 号：R473.73[医药卫生—护理学]