摘要
目的了解化疗期消化道癌症患者的相关症状,探讨其症状群的种类、数量及影响因素,为针对性的症状群管理提供参考。方法选取2015年1—7月在安徽省合肥市三所三级甲等医院肿瘤内科住院的化疗期消化道癌症患者180例,采用安德森症状评估量表中文版(MDASI-C)进行症状调查,采用探索性因子分析提取症状群,采用多元线性回归分析症状群严重度的影响因素。结果化疗期消化道癌症患者症状发生率及严重度评分前4位的均是疲乏〔96.7%(174/180),4.0(4.0)分〕、食欲不振〔87.8%(158/180),4.0(3.0)分〕、苦恼〔86.7%(156/180),3.0(3.0)分〕、悲伤〔82.2%(148/180),3.0(4.0)分〕。探索性因子分析得出四大症状群:身心症状群(疼痛、睡眠不安、苦恼、悲伤)、能量不足症状群(疲乏、食欲不振、口干)、消化道症状群(恶心、呕吐)、神经毒性症状群(健忘、麻木),其内部一致性分别为0.70、0.68、0.82、0.65。多元线性回归分析结果显示,身心症状群严重度的影响因素为饮酒和化疗方案(P<0.05);消化道症状群严重度的影响因素为化疗次数(P<0.05);神经毒性症状群严重度的影响因素为化疗次数、化疗方案、癌症分期(P<0.05)。结论化疗期消化道癌症患者相关症状发生率高,也较严重,其中一些症状构成了症状群,饮酒、化疗方案、化疗次数、癌症分期是症状群严重度的影响因素。
Objective To explore related symptom clusters of patients with digestive tract cancers during chemotherapy,and to investigate the categories,number and influencing factors,in order to provide references for the targeted management of symptom clusters.Methods We enrolled 180 inpatients with digestive tract cancers undergoing chemotherapy from the department of medical oncology of three grade A class three hospitals in Hefei of Anhui Province between January to July in 2015.Anderson Symptom Assessment Scale Chinese version（ MDASI- C） was adopted to conduct survey,and syndrome clusters were extracted using exploratory factor analysis.Multiple linear analysis was employed to conduct analysis on the influencing factors for the severity of syndrome clusters.Results During chemotherapy,the first four syndromes with the highest incidence and severity degree were fatigue 〔96.7%（ 174 /180）,4.0（ 4.0） 〕,poor appetite 〔87.8%（ 158 /180）,4.0（ 3.0） 〕,worry〔86.7%（ 156 /180）,3.0（ 3.0） 〕and sadness 〔82.2%（ 148 /180）,3.0（ 4.0） 〕.By exploratory factor analysis,we found out four syndrome clusters： mind and body syndrome clusters（ pain,uneasy sleep,worry,sadness）,energy deficiency syndrome clusters（ fatigue,poor appetite and xerostomia）,syndrome clusters of digestive tract（ nausea and vomit） and neurovirulence syndrome clusters（ amnesia and numb）,and the internal consistency was 0.70,0.68,0.82 and 0.65 respectively.Multiple regression analysis showed that the influencing factors for the severity of mind and body syndrome clusters were alcohol consumption and chemotherapy scheme（ P〈0.05）; the influencing factor for the severity of syndrome clusters of digestive tract was the time of chemotherapy（ P〈0.05）; and the influencing factors for the severity of neurovirulence syndrome clusters were the time of chemotherapy,chemotherapy scheme and cancer staging（ P〈0.05）.Conclusion The incidence of syndromes in patients with digestive tract cancers during chemotherapy is high,and the syndromes are severe.Some syndromes constitute syndrome clusters.Alcohol consumption,chemotherapy scheme,the time of chemotherapy and cancer staging are influencing factors for the severity of these syndrome clusters.
出处
《中国全科医学》
CAS
CSCD
北大核心
2016年第1期59-62,77,共5页
Chinese General Practice
基金
安徽省自然科学基金资助项目(1608085MH183)
安徽省科技厅国际科技合作计划资助项目(1303063025)
关键词
消化系统肿瘤
放化疗
辅助
症状群
影响因素分析
Digestive system neoplasms
Chemoradiotherapy
adjuvant
Symptom clusters
Root cause analysis
