原发性肝癌病人出院时症状群及前哨症状的调查研究

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Investigation on symptom clusters and sentinel symptom of patients with primary liver cancer at discharge

LIU Ting， ZHENG Ruishuang， WANG Yanhui， GUO Qing， WANG Ying， DONG Fengqi*

Tianjin Medical University Cancer Institute and Hospital， National Clinical Research Center for Cancer， Tianjin's Clinical Research Center for Cancer， Key Laboratory of Cancer Prevention and Therapy， Tianjin 300060 China

*Corresponding Author  DONG Fengqi， E⁃mail： dongfengqi512@126.com

Abstract  Objective：To investigate the symptom clusters and sentinel symptoms of primary liver cancer patients discharged from hospital under enhanced recovery after surgery（ERAS）.Methods：A total of 186 patients with primary liver cancer who were hospitalized in the hepatobiliary oncology department of a tertiary grade A cancer hospital in Tianjin from September 2022 to May 2023 were selected by convenience sampling method.All patients underwent enhanced recovery after surgery.A study was conducted by using the general data questionnaire，M.D.Anderson Symptom Inventory⁃Chinese（MDASI⁃C） and the Symptom Module specific to Primary Liver Cancer（TSM⁃PLC）.Symptom clusters were extracted by principal component analysis and orthogonal rotation of maximum variance，and sentinel symptoms within each symptom group were determined according to Apriori algorithm association analysis.Results：Patients with primary liver cancer who implemented enhanced recovery after surgery had four symptom groups：emotional symptom group，pain⁃related symptom group，digestive tract symptom group and surgery⁃related symptom group.Distress，shortness of breath，loss of appetite and dry mouth were the sentinel symptoms of emotional symptom group，pain related symptom group，digestive symptom group and surgery related symptom group respectively.Conclusions：Patients with primary liver cancer who implemented enhanced recovery after surgery were troubled by various symptoms after surgery，and the symptoms cooperated with each other to form 4 symptom groups，and sentinel symptoms existed in each symptom group.Nursing staff should evaluate patients' symptom groups timely and accurately，and formulate targeted nursing intervention strategies based on sentinel symptoms to reduce patients' symptoms and improve patients' quality of life.

Keywords  primary liver cancer； symptom clusters； sentinel symptom； enhanced recovery after surgery； investigation and research

摘要  目的：调查加速康复外科模式下原发性肝癌病人出院时症状群及其前哨症状。（剩余13857字）