肺癌患者围手术期症状群的纵向调查研究  

Perioperative symptom clusters in patients with lung cancer:A longitudinal investigation

作　　者：张欢欢 张娜[1] 刘燕[2] ZHANG Huanhuan;ZHANG Na;LIU Yan(Department of Thoracic Surgery,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital Chinese Academy of Medical Sciences,Beijing,100021,P.R.China;Department of Nursing,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital Chinese Academy of Medical Sciences,Beijing,100021,P.R.China)

机构地区：[1]国家癌症中心,国家肿瘤临床医学研究中心,中国医学科学院肿瘤医院胸外科,北京100021 [2]国家癌症中心,国家肿瘤临床医学研究中心,中国医学科学院肿瘤医院护理部,北京100021

出　　处：《中国胸心血管外科临床杂志》2025年第4期508-514,共7页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的调查肺癌患者围手术期各个时间点症状的发生率、严重程度及其症状群的纵向轨迹,为临床医务人员实施预见性护理及症状群的动态管理提供科学依据。方法采用纵向调查的方法,分别于术前、术后1~2 d、出院当天及出院后2周通过面对面及电话随访方式对在中国医学科学院肿瘤医院胸外科4个病区行胸腔镜肺部手术的肺癌患者进行问卷调查。调查工具为中文版安德森症状评估量表肺癌模块。结果本研究共纳入192例肺癌患者,其中男59例、女133例,平均年龄(55.68±11.01)岁。肺癌患者手术前共存在2个症状群,即呼吸道-胃肠道症状群和情绪/心理-睡眠障碍症状群;术后1~2 d共存在3个症状群,即呼吸道症状群、胃肠道症状群及情绪/心理-睡眠障碍症状群;出院当天共存在3个症状群,即疼痛-疲乏-情绪/心理症状群、呼吸道症状群和胃肠道症状群;出院后2周共存在2个症状群,分别为疼痛-疲乏-呼吸道症状群和呼吸道症状群。肺癌患者围手术期各个时间点症状群内症状组成存在差异。结论肺癌患者围手术期内共出现4种症状群,即疼痛-疲乏-睡眠障碍症状群、胃肠道症状群、呼吸道症状群及情绪/心理症状群,不同时间点肺癌患者存在的症状群具有相对稳定性,但症状群内的症状呈动态变化。医护人员应高度重视并持续监测肺癌患者围手术期症状群的动态变化,提前做好相关宣教及护理,并根据症状群评估结果及时调整管理方案。Objective To investigate the incidence,severity and longitudinal trajectories of symptoms at various time points in the perioperative period of lung cancer patients,and to provide scientific basis for clinical staff to implement predictive nursing and dynamic management of symptom clusters.Methods A prospective longitudinal investigation was conducted.The patients with lung cancer who underwent thoracoscopic lung surgery in four wards of the Department of Thoracic Surgery in our hospital were investigated by face-to-face and telephone follow-up before surgery,1-2 days after surgery,on the day of discharge and 2 weeks after discharge.The investigation tool was the revised Chinese version of MD Anderson Symptom Inventory lung cancer specific module.Results A total of 192 patients with lung cancer were included in this study,including 59 males and 133 females,with an average age of(55.68±11.01)years.There were two symptom clusters(respiratory-gastrointestinal and emotional/psychological-disturbed sleep symptom clusters)before surgery,three symptom clusters(respiratory,gastrointestinal,and emotional/psychological-disturbed sleep symptom clusters)1-2 days after surgery,three symptom clusters(pain-fatigue-emotional/psychological,respiratory,and gastrointestinal symptom clusters)on the day of discharge,and two symptom clusters(pain-fatigue-respiratory and respiratory symptom clusters)2 weeks after discharge.The composition of symptoms was different in each time point during perioperative period.Conclusion There are four symptom clusters in patients with lung cancer during perioperative period,which are pain-fatigue-disturbed sleep symptoms,gastrointestinal symptoms,respiratory symptoms and emotional/psychological symptoms.The symptom clusters of lung cancer patients at different time points are relatively stable,but the symptoms within the symptom clusters show dynamic changes.Medical staff should attach great importance to and continuously monitor the dynamic changes of perioperative symptom groups of lung cancer pati

关 键 词：肺癌 围手术期 症状群 纵向调查 

分 类 号：R734.2[医药卫生—肿瘤]