结直肠癌术后首次化疗患者症状群及核心症状的研究  

A study on the symptom clusters and core symptoms of patients undergoing first-time chemotherapy after colorectal cancer surgery

作　　者：郑存风 刘海静[2] 高杰[3] 秦娅 张清[1] ZHENG Cunfeng;LIU Haijing;GAO Jie;QIN Ya;ZHANG Qing(School of Nursing,Tianjin Medical University,Tianjin 300070,China;Department of General Surgery,Tianjin Medical University General Hospital,Tianjin 300052,China;Department of Anorectalsurgery,The Second Hospital of Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]天津医科大学护理学院,天津300070 [2]天津医科大学总医院普外科,天津300052 [3]天津医科大学第二医院肛肠外科,天津300211

出　　处：《天津医科大学学报》2025年第2期161-166,共6页Journal of Tianjin Medical University

摘　　要：目的:通过调查结直肠癌术后首次化疗患者症状分布及症状群组成,识别核心症状。方法:便利选取2023年1月至2023年12月天津医科大学总医院普外科住院治疗的152例结直肠癌术后首次化疗患者作为研究对象,采用一般资料调查表、中文版安德森症状评估量表结直肠癌模块进行调查。通过探索性因子分析法提取症状群;运用R语言构建症状网络,分析中心性指标识别核心症状。结果:结直肠癌术后首次化疗患者症状发生率排名前5位的症状为疲乏(85.5%)、食欲下降(80.3%)、情绪低落(61.8%)、麻木感(60.5%)、苦恼(57.9%)。运用主成分分析法对22个症状进行分类,得出5个症状群,分别为消化道-心理症状群、病感症状群、结直肠癌特异性症状群、疼痛睡眠障碍症状群、神经毒性症状群,方差贡献率分别为40.317%、9.930%、9.306%、5.707%、4.687%,累积方差贡献率为69.947%。在症状网络中,情绪低落和苦恼的强度、紧密中心性、中介中心性均最大,为核心症状。结论:结直肠癌术后首次化疗患者症状群为消化道-心理症状群、病感症状群、结直肠癌特异性症状群、疼痛睡眠障碍症状群、神经毒性症状群,以情绪低落和苦恼为核心症状。Objective:To identify the core symptoms by investigating the distribution of symptoms and the composition of symptom clusters in patients underwent first-time chemotherapy after colorectal cancer surgery.Methods:A total of 152 patients who underwent first-time chemotherapy after colorectal cancer surgery and hospitalized in the Department of General Surgery at Tianjin Medical University General Hospital from January 2023 to December 2023 were selected as the research subjects.The survey was conducted using the General Information Questionnaire and the Chinese version of M.D.Anderson symptom inventory scale for colorectal cancer.Symptom clusters were extracted through exploratory factor analysis;R language was used to construct a symptom network and analyze central indicators to identify core symptoms.Results:The top five symptoms with the highest incidence of symptoms in patients undergoing first-time chemotherapy after colorectal cancer surgery were fatigue(85.5%),decreased appetite(80.3%),emotional depression(61.8%),numbness(60.5%),and distress(57.9%).Using principal component analysis,22 symptoms were classified and 5 symptom clusters were identified,including gastrointestinal-psychological symptom clusters,disease symptom clusters,colorectal cancer specific symptom clusters,pain-sleep disorder symptom clusters,and neurotoxicity symptom clusters,the variance contribution rate were 40.317%,9.930%,9.306%,5.707%,4.687%.The cumulative variance contribution rate was 69.947%.In the symptom network,the strength,closeness,and betweenness of emotional depression and distress were the highest,and they were the core symptoms.Conclusion:The symptom clusters of patients undergoing first-time chemotherapy after colorectal cancer surgery include gastrointestinal-psychological symptom clusters,disease symptom clusters,colorectal cancer specific symptom clusters,pain-sleep disorder symptom clusters,and neurotoxicity symptom clusters,with emotional depression and distress as the core symptoms.

关 键 词：结直肠癌 症状群 化疗 核心症状 网络分析 

分 类 号：R735.3[医药卫生—肿瘤]