食管癌放疗病人症状群的纵向研究

Longitudinal study of symptom clusters in patients with esophageal cancer treated with radiotherapy

目的:探讨食管癌病人在放疗期间症状群变化情况。方法:使用便利抽样法选取在2021年6月—2021年11月就诊于河北省某三级甲等医院拟行放疗的215例食管癌病人,采用食管癌症状评估量表在首次放疗(T1)、放疗第15次时(T2)及放疗第30次时(T3)进行评估,运用探索性因子分析法提取症状群。结果:最后155例病人完成调查。在放疗的3个时间点中,病人症状的发生率和严重程度不同。有21~26项症状的发生率在20%以上,其中吞咽困难、疲乏、皮肤瘙痒、口干、恶心等症状的严重程度较大,症状的发生率和严重程度基本随时间变化而变化。进食困难症状群、消化道症状群、能量不足⁃心理症状群稳定存在,在放疗的中后期,病人开始出现放疗不良反应症状群。结论:食管癌病人在放疗期间存在稳定且动态变化的症状群,应密切关注症状变化,开展相应的症状管理。

Objective:To investigate the symptom clusters changes of patients with esophageal cancer during radiotherapy.Methods:Totally 215 esophageal cancer patients,who were treated in a tertiary Grade A hospital in Hebei province from June 2021 to November 2021,were selected using convenience sampling and investigated using Esophageal cancer symptom Assessment Scale at the first(T1),15th time(T2)and 30th time(T3)radiotherapy.The exploratory factor analysis was used to extract symptom clusters.Results:Totally 155 patients completed the survey.Patients differed in the incidence and severity of symptoms at the three time points during radiotherapy.The incidence of 21~26 symptoms was more than 20%,among which dysphagia,fatigue,pruritus,dry mouth,nausea and other symptoms were more serious,and the incidence and severity of symptoms changed with time.Symptom groups of dysphoria,digestive tract symptom groups,energy deficiency⁃psychological symptom groups were stable.In the middle and late stage of radiotherapy,patients began to appear symptom group of adverse reaction to radiotherapy.Conclusion:Patients with esophageal cancer undergoing radiotherapy had stable and dynamic symptom clusters during radiotherapy,so it is necessary to pay closely attention to the symptom changes and carry out corresponding symptom management.