目的 探索食管癌患者围化疗期间症状群构成及动态变化,为其化疗期间症状管理提供依据。 方法 选取 2021 年 6 月至 2022 年 12 月南通市肿瘤医院肿瘤中心治疗的食管癌化疗患者 168 例作为研究对象,采用基本信息调查表、安德森症状 测评量表、症状补充问卷分别在首次入院(T1 )、首次化疗(T2 )、第 2 次化疗(T3 )、末次化疗(T4 )时进行问卷调查。 提取症状 群使用探索性因子分析。 结果 T1 ~ T4 时间节点的症状发生率>20%的数目分别为 12、20、22、18 个。 症状发生率 12. 50% ~ 94. 12%。 探索性因子分析结果:食管癌患者围化疗期间在 T1 ~ T4 时间节点分别提取症状群个数 3、5、6、6 个。 其中,睡眠紊乱 症状群、认知相关症状群、心理神经症状群持续存在于 T1 ~ T4 时间节点,疼痛症状群、消化道症状群存在于 T2 ~ T4 时间节 点,活动耐力症状群存在于 T3 ~ T4 时间节点。 结论 食管癌患者化疗期间存在多种症状,T3 、T4 时间节点的症状群构成较为稳定。 临床工作人员应关注食管癌患者化疗期间的症状群,并采取相应措施积极进行干预以缓解多种症状,进而降低症状群对 患者的影响。

Objective To explore the symptom group composition and dynamic change track of patients with esophageal cancer during chemotherapy and provide evidence for symptom management of patients with esophageal cancer during chemotherapy. Method A total of 168 patients with esophageal cancer treated by chemotherapy in Nantong Cancer Hospital from June 2021 to December 2022 were selected as the study objects. General data questionnaire Anderson symptom assessment scale and symptom supplement questionnaire were used at the first admission T1 first chemotherapy T2 second chemotherapy T3 and last chemotherapy T4 . Symptom cluster were extracted by exploratory factor analysis. Result There were 12 20 22 and 18 symptoms with an incidence greater than 20% at each time node from T1 to T4 respectively. The incidence ranged from 12. 50% to 94. 12%. Exploratory factor analysis revealed Three five six and six symptom cluster were extracted from T1 T2 T3 and T4 respectively during chemotherapy for patients with esophageal cancer. Among them sleep disorder symptom group cognitive-related symptom group and psychoneurotic symptom group persisted from T1 to T4 pain symptom group digestive tract symptom group existed from T2 -T4 . Activity tolerance symptom group existed in T3 - T4 . Conclusion Patients with esophageal cancer have multiple symptoms and high incidence during chemotherapy and the composition of T3 and T4 symptom cluster is relatively stable. Nurses should pay attention to the symptom cluster of postoperative patients with esophageal cancer during chemotherapy and take appropriate measures to actively intervene to alleviate various symptoms so as to reduce the impact on patients.