摘要
目的本研究旨在探讨原发性肝癌患者在接受经动脉化疗栓塞术后的症状特征,识别核心症状并分析其影响因素,为精准症状管理提供参考。方法采用便利抽样法,纳入2024年3月至2024年10月西南医科大学附属医院收治207例原发性肝癌经动脉化疗栓塞术后患者,在术后第1天,采用安德森症状评估量表和原发性肝癌特异性模块评估患者症状的发生率和严重程度,采用R 4.3.1软件进行网络分析,识别核心症状;采用单因素及多元线性回归分析探讨原发性肝癌经动脉化疗栓塞术后患者核心症状的影响因素。结果原发性肝癌经动脉化疗栓塞术后患者发生率较高的症状依次是疲乏、心理痛苦和疼痛,严重程度较高的症状分别是疲乏、心理痛苦和恶心,网络分析显示,心理痛苦症状的强度(r_(s)=2.25)、紧密中心性(r_(c)=0.063)和中介中心性(r_(b)=190)最高,是原发性肝癌经动脉化疗栓塞术后患者的核心症状。多元线性回归分析结果显示,年龄、婚姻情况、家庭人均月收入和白蛋白水平为原发性肝癌经动脉化疗栓塞术后患者心理痛苦症状严重程度得分的影响因素(P<0.05)。结论研究发现,在原发性肝癌患者TACE术后症状中,心理痛苦是整个症状网络的核心,而疲乏则是发生最普遍、程度最重的症状。此外,患者的年龄、婚姻状况、家庭人均月收入和白蛋白水平是影响这一核心症状的关键因素。提示医务人员在关注疲乏症状的同时,可针对心理痛苦症状及其影响因素开展干预措施,有助于提高原发性肝癌经动脉化疗栓塞术后患者症状管理的效率。
Objective This study aimed to explore symptom characteristics in patients with primary liver cancer after transarterial chemoembolization(TACE),identify core symptoms,and analyze their influencing factors,thereby providing a reference for precision symptom management.Methods Using convenience sampling,207 patients with primary liver cancer who underwent TACE in the Affiliated Hospital of Southwest Medical University from March 2024 to October 2024 were enrolled.On postoperative day 1,symptom incidence and severity were assessed using the Anderson Symptom Assessment Scale and the primary liver cancer–specific module.Network analysis was performed with R software(version 4.3.1)to identify core symptoms.Univariate analysis and multivariable linear regression were conducted to explore factors associated with core symptoms in patients with primary liver cancer after TACE.Results The symptoms with the highest incidence after TACE were fatigue,psychological distress,and pain,in descending order.The most severe symptoms were fatigue,psychological distress,and nausea.Network analysis showed that psychological distress had the highest strength(r_(s)=2.25),closeness centrality(r_(c)=0.063),and betweenness centrality(r_(b)=190),indicating that it was the core symptom in patients with primary liver cancer after TACE.Multivariable linear regression analysis revealed that age,marital status,average monthly household income per capita,and serum albumin level were influencing factors for the severity score of psychological distress(P<0.05).Conclusion Among symptoms after TACE in patients with primary liver cancer,psychological distress is the core of the overall symptom network,whereas fatigue is the most prevalent and most severe symptom.In addition,age,marital status,average monthly household income per capita,and serum albumin level are key factors influencing this core symptom.These findings suggest that,while paying attention to fatigue,healthcare professionals should implement targeted interventions for psychological distress and its influencing factors to improve the efficiency of symptom management in patients with primary liver cancer after TACE.
作者
吴柳
古治容
陈静
郑思琳
WU Liu;GU Zhirong;CHEN Jing;ZHENG Silin(Southwest Medical University,Luzhou Sichuan 646000,China;Department of Hepatobiliary Surgery,Affiliated Hospital of Southwest Medical University,Luzhou Sichuan 646000,China;Department of Nursing,Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan,China)
出处
《临床研究》
2025年第12期1-9,共9页
Clinical Research
关键词
原发性肝癌
动脉化疗栓塞术
核心症状
症状网络
primary liver cancer
transarterial chemoembolization
core symptoms
symptom network
