头颈癌术后气管切开患者症状群及其影响因素决策树预测模型的建立  

Establishment of a decision tree prediction model for symptom groups and influencing factors in patients with tracheotomy after operation for head and neck cancer

作　　者：王淑云[1] 刘志煜 石晏荣 王培培 吴楠楠 王雪梅[3] Wang Shuyun;Liu Zhiyu;Shi Yanrong;Wang Peiei;Wu Nannan;Wang Xuemei(Department of Head and Neck Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Department of Cardiovascular Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Second Department of Hepatobiliary Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院咽喉头颈外科,郑州450000 [2]郑州大学第一附属医院心血管内科,郑州450000 [3]郑州大学第一附属医院肝胆胰外二科,郑州450000

出　　处：《中华现代护理杂志》2023年第22期3002-3008,共7页Chinese Journal of Modern Nursing

基　　金：国家自然科学基金(U2004109)。

摘　　要：目的探讨头颈癌术后气管切开患者的症状群及其影响因素,为制订精准症状管理策略提供参考。方法采用便利抽样法,选取2020年4月—2023年1月在郑州大学第一附属医院接受治疗或复查的289例头颈癌术后气管切开患者为研究对象。应用患者一般资料调查表和安德森症状调查表-头颈对患者进行测评,利用探索性因子分析头颈癌术后气管切开患者的症状群,采用单因素分析和决策树构建各症状群预测模型。本研究共发放问卷289份,剔除无效问卷18份,最终回收有效问卷271份,问卷有效回收率为93.8%。结果共提炼出睡眠-躯体症状群、头颈癌放疗-心理症状群、头颈癌特异性症状群3个症状群。决策树预测模型显示,头颈癌术后气管切开患者症状的核心影响因素为疾病分期和手术方式,其次为术前情绪问题、婚姻状况和主要照顾者;该模型的总体正确百分率分别为61.6%、67.2%、62.0%,并且在预测未发生候选症状群的正确预测率分别为96.1%、86.4%、62.4%,拟合效果较好。结论头颈癌术后气管切开患者存在多个症状群,疾病分期和手术方式为各症状群核心影响因素,决策树模型有利于医务人员高效识别各症状群高发人群和制订精准干预方案。ObjectiveTo investigate the symptom groups and influencing factors in patients with tracheotomy after operation for head and neck cancer and to provide reference for developing accurate symptom management strategies.MethodsUsing the convenient sampling method,a total of 289 patients with head and neck cancer who received treatment or reexamination in the First Affiliated Hospital of Zhengzhou University from April 2020 to January 2023 were selected as the research objects.The patients were assessed with the general information questionnaire and M.D.Anderson Symptom Inventory-Head and Neck(MDASI-HN).Exploratory factor analysis was used to analyze the symptom groups of patients with head and neck cancer after tracheotomy,and single factor analysis and decision tree were used to construct the prediction model of each symptom group.A total of 289 questionnaires were sent out in this study,18 invalid questionnaires were excluded,and 271 valid questionnaires were finally recovered,with an effective recovery rate of 93.8%.ResultsThree symptom groups were extracted,including sleep-body symptom group,head and neck cancer radiotherapy-psychological symptom group and head and neck cancer specific symptom group.The decision tree prediction model showed that the core factors affecting the symptoms of patients with tracheotomy after head and neck cancer were disease stage and operation mode,followed by preoperative emotional problems,marital status and main caregivers.The overall correct percentages of the model were 61.6%,67.2%and 62.0%,respectively,and the correct prediction rates of the non-occurrence candidate symptom groups were respectively 96.1%,86.4%and 62.4%,indicating a good fitting effect.ConclusionsThere are multiple symptom groups in patients with tracheotomy after head and neck cancer surgery.The disease stage and surgical method are the core influencing factors of each symptom group.The decision tree model is helpful for medical staff to effectively identify people with high incidence of various symptom groups a

关 键 词：头颈部肿瘤 气管切开 症状群 决策树模型 

分 类 号：R473.73[医药卫生—护理学]