直肠癌低位前切除术后患者症状群的纵向研究  

作　　者：华悦君 刘亚婷 谢玲女[1] 蒋丽丽[1] 陈秀云[1] 

机构地区：[1]浙江省肿瘤医院/中国科学院杭州医学研究所,310022

出　　处：《浙江临床医学》2023年第5期729-731,734,共4页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2021KY102)。

摘　　要：目的分析直肠癌低位前切除术后患者症状群的种类、构成及动态变化,为有效实施症状管理提供依据。方法采用前瞻性纵向研究方法,应用一般资料调查问卷和直肠癌低位前切除术后症状评估量表对122例接受低位前切除的直肠癌患者于术后1、3、6、9、12个月5个时间点进行动态纵向调查,通过主成分分析法对5个时间点发生率≥20%的症状进行归类,对症状群的变化进行描述分析。结果直肠癌低位前切除术后患者症状经历可聚集为5个症状群,包括肠道功能症状群、能量缺乏症状群、疼痛-睡眠障碍症状群、心理情感症状群和性生活障碍症状群。从T1~T5症状群的数量逐渐减少,依次为4、5、4、3、2个,肠道功能症状群普遍而持久。群内症状的严重程度逐渐向好演变。结论直肠癌低位前切除患者术后存在多个症状群,医护人员应加强术后症状的动态评估,并以症状群为单位积极干预,提高患者的生活质量。Objective To analyze symptom groups'types,composition,and dynamic changes of rectal cancer patients who underwent low anterior resection and to provide a basis for effective implementation of symptom management.Methods A prospective longitudinal study was conducted to dynamically analyze the changes of postoperative symptoms groups of the patients with rectal cancer who underwent low anterior resection(LAR).A total of 122 eligible patients were included in the study.The general data questionnaire,and symptom assessment scale of the rectal cancer patients who underwent low anterior resection were analyzed in five-time points after surgery:one month,three months,six months,nine months,and 12 months.Besides,the symptoms with an incidence of≥20%at five-time points were classified by principal component analysis.Results The symptoms of rectal cancer patients who underwent low anterior resection were divided into five symptom groups:intestinal function symptom cluster,energy deficiency symptom cluster,pain-sleep disorder symptom cluster,psycho-affective symptom cluster,and sexual disturbance symptom groups.From T1 to T5,the number of symptom clusters decreased,and the severity of symptoms within the groups gradually improved.Among the above symptom clusters mentioned,intestinal function symptom clusters were common and persistent.Conclusion There are multiple symptom groups in patients with rectal cancer after low anterior resection.Medical staff should strengthen the dynamic evaluation of postoperative symptoms and actively intervene according to the accurate symptom cluster unit to improve patients'quality of life.

关 键 词：直肠癌 低位前切除术 症状群 纵向研究 

分 类 号：R735.37[医药卫生—肿瘤]