护理研究2026，Vol.40Issue(14)：2414-2422,9.DOI:10.12102/j.issn.1009-6493.2026.14.004
直肠癌病人新辅助化疗期间的症状群轨迹及其与术后康复指标的相关性研究
Symptom cluster trajectories during neoadjuvant chemotherapy and their association with postoperative recovery outcomes in rectal cancer patients
摘要
Abstract
Objective:To investigate the trajectories of symptom clusters in rectal cancer patients undergoing neoadjuvant chemotherapy and to analyze their correlation with postoperative recovery indicators.Methods:A convenience sampling method was used to select 120 rectal cancer patients admitted to a tertiary grade A hospital in Shanghai city from April to December 2024 as study subjects.Patient symptom burden was assessed at five time points,namely before neoadjuvant chemotherapy(T1),after the first chemotherapy cycle(T2),after the second chemotherapy cycle(T3),after the third chemotherapy cycle(T4),and 3-5 days before surgery(T5).Exploratory factor analysis was employed to extract symptom clusters.Latent class growth modeling(LCGM)was used to identify the trajectory classes of the symptom clusters.Postoperative recovery indicators,including body weight,diet type,wound healing status,bowel function,and complication severity,were compared among different trajectory classes of symptom clusters.Results:There three stable symptom clusters were consistently identified across the five time points in rectal cancer patients,namely a core neurotoxicity symptom cluster,a gastrointestinal reaction symptom cluster,and a psychological stress symptom cluster.The cumulative variance contribution rate ranged from 66.71%to 80.60%.Patient symptom burden increased at T3 and peaked at T4.LCGM identified three trajectory classes for the core neurotoxicity symptom cluster,two for the gastrointestinal reaction symptom cluster,and two for the psychological stress symptom cluster.Statistically significant differences(all P<0.05)were found in body weight,diet type,bowel function,and complication severity among different trajectory classes of the core neurotoxicity symptom cluster.Significant differences(all P<0.05)were found in body weight,bowel function,and complication severity among different trajectory classes of the gastrointestinal reaction symptom cluster.Significant differences(all P<0.05)were found in body weight,diet type,and wound healing status among different trajectory classes of the psychological stress symptom cluster.Conclusions:Symptom clusters in rectal cancer patients undergoing neoadjuvant chemotherapy show a progressively worsening trend with group heterogeneity.The trajectory classes of each symptom cluster have a certain impact on patients' postoperative recovery indicators.关键词
直肠癌/新辅助化疗/症状群/潜类别增长模型/术后康复Key words
rectal cancer/neoadjuvant chemotherapy/symptom clusters/latent class growth model/postoperative recovery引用本文复制引用
郭文悦,罗珏,张雯,张晓菊..直肠癌病人新辅助化疗期间的症状群轨迹及其与术后康复指标的相关性研究[J].护理研究,2026,40(14):2414-2422,9.基金项目
上海市卫生健康委员会卫生行业临床研究专项项目,编号:202340261 （）
复旦大学-复星护理科研基金项目,编号:FNF202335 （）
