急性淋巴细胞白血病患儿化疗期疲乏状况及影响因素调查分析

Fatigue of children with acute lymphoblastic leukemia during chemotherapy and influencing factors

目的 了解急性淋巴细胞白血病（ALL）患儿化疗期疲乏状况及影响因素.方法 于2014年2月—2016年8月采用中文版PedsQLTMMFS儿童多维疲乏量表和ALL患儿化疗期间不适症状调查表对郑州市某三甲儿童医院的216例5~15岁ALL患儿进行问卷调查.结果 本次评估ALL患儿化疗期间疲乏总分为（31.71±16.66）分,其中全身疲乏维度总分（11.67±6.29）分,睡眠疲乏维度总分（10.99±5.57）分,认知疲乏维度总分（9.10±6.84）分;ALL患儿化疗期全身疲乏发生率90.74%,睡眠疲乏发生率95.83%,认知疲乏发生率81.94%;ALL患儿化疗期全身疲乏的主影响因素为体重下降、食欲下降、精力不足,共解释疲乏变异的72.8%;睡眠疲乏的主影响因素为体重下降、感到烦躁,共解释疲乏变异的51.2%;认知疲乏的主影响因素为难以集中精神、口腔溃疡,共解释疲乏变异的44.2%.结论 ALL患儿化疗期疲乏症状普遍存在,且处于中等偏下水平,在患儿化疗期进行疲乏症状管理时,积极治疗患儿的相关症状,从而降低疲乏水平.

Objective To investigate fatigue in children with acute lymphoblastic leukemia （ALL） during chemotherapy,and influencing factors.Methods From Feburary 2014 to August 2016, 216 children with ALL,from 5 to 15 years old,treated in a Grade III,Level A children＇s hospital in Zhengzhou,were surveyed by Peds QLTM multidimensional fatigue scale （Chinese version） and Questionnaire on discomfort in ALL children during chemotherapy.Results During chemotherapy,total scores of fatigue in the ALL children were （31.71±16.66） ,with fatigue of the whole body （11.67±6.29）,of sleeping （10.99±5.57）,and of cognition （9.10±6.84）;during chemotherapy,incidence of fatigue of the whole body was 90.74%,of sleeping 95.83%, and of cognition 81.94%. Main influencing factors of fatigue of the whole body were weight loss,appetite loss and lack of energy,accounting for 72.8% of fatigue variation;that of sleeping were weight loss and irritability, accounting for 51.2% of fatigue variation;and that of cognition were difficulty in concentration and oral ulcer, accounting for 44.2% of fatigue variation.Conclusions During chemotherapy,fatigue in ALL children is common and is below average level. When managing fatigue symptoms in ALL children,nurses should actively treat the symptoms,so as to reduce the level of fatigue.