开颅术后胶质瘤患者症状群及前哨症状的研究

Study on the sysptom clusters and sentinel symptoms in patients with glioma after craniotomy

目的调查开颅术后的胶质瘤患者症状群及不同症状群的前哨症状,为医护人员开展此类人群的症状管理提供参考。方法选取2022年1-5月在我院住院的168例开颅术后的胶质瘤患者为研究对象,采用自行研制的一般资料调查表及安德森症状评估量表-脑肿瘤特异模块对其进行调查。采用主成分分析法提取症状群,基于Apriori算法关联分析结果,判定各症状群内前哨症状。结果本研究168例患者中,睡眠不安发生率最高,且情绪困扰、工作/家务劳动困扰在症状困扰中较为严重。开颅术后胶质瘤患者存在4个症状群,包括疾病行为症状群、神经相关症状群、情绪-食欲相关症状群和其他症状群。虚弱无力是患者神经相关症状群的前哨症状,口干是情绪-食欲相关症状群的前哨症状,疾病行为症状群及其他症状群无明显前哨症状。结论开颅术后胶质瘤患者存在症状群,且神经相关症状群及情绪-食欲相关症状群存在前哨症状。建议医护人员将前哨症状作为症状群管理的切入点,可依据症状群及前哨症状为患者制定针对性干预措施。

Objective To explore the symptom clusters and their sentinel symptoms in patients with glioma after craniotomy,so as to provide a reference for medical staff to carry out symptom management of such people.Methods A total of 168 patients with glioma after craniotomy in the Beijing Grade-Three hospital from January to May 2022 were selected as the research objects by the convenient sampling method,and general information questionnaire and the M.D.Anderson Symptom Inventory-Brain Tumor were used to investigate.Symptom cluster was extracted by principal component analysis,and sentinel symptoms in each symptom cluster was identified based on the correlation analysis results of Apriori algorithm.Results Among 168 patients of this study,sleep disorder symptom occurrence of patients with glioma after craniotomy was the highest,the incidence of mood distress and work/housework distress were serious.There were 4 symptom clusters in patients with glioma after craniotomy,including disease behavior symptom cluster,nerve related symptom cluster,emotion-appetite related symptom cluster,and other symptom cluster.Weakness was the sentinel symptom of nerve related symptom cluster,and xerostomia was the sentinel symptom of emotion-appetite related symptom cluster,and disease behavior symptom cluster and other symptom cluster had no obvious sentinel symptoms.Conclusion There are symptom clusters in patients with glioma after craniotomy,and sentinel symptoms exist in the neuro-related symptom cluster and emotion-appetite related symptom cluster.It is recommended that medical works shall take sentinel symptom as the entry point for symptom cluster management to formulate targeted interventions for patients according to symptom clusters and sentinel symptoms。