日间肺癌手术患者出院后症状纵向变化轨迹及影响因素研究

doi:10.3761/j.issn.2096-7446.2025.11.009

Abstract

Abstract:

Objective To explore the dynamic changes of symptoms after discharge among patients undergoing daytime lung cancer surgery and analyze their influencing factors. Methods A longitudinal study was conducted in a tertiary hospital in Zhejiang Province，enrolling patients who underwent daytime lung cancer surgery between October 2023 and January 2024. Postoperative symptoms were assessed using a lung cancer symptom scale on days 1，3，14，and 30 after discharge. Group-Based Trajectory Modeling（GBTM） was used to identify the post-discharge symptom trajectory categories among patients. Patient characteristics among different trajectory groups were compare，and the mean symptom response index was used to analyze the longitudinal changes of individual postoperative symptoms. Results Three trajectory groups were identified：mild symptoms-slowly decreasing group（n=184， 89.32%），severe symptoms-rapidly decreasing group（n=19，9.22%），and mild symptoms-worsening group（n=3，1.46%）. Significant differences were observed among these post-discharge symptom trajectory groups in terms of age，surgical approach，and tumor type（P<0.05）. On the first day after discharge，cough and pain were the most common symptoms，occurring in 180 cases（87.38%） and 197 cases（95.63%） respectively. Cough remained the predominant symptom on day 30 post-discharge（n=129，62.62%）. In the mean symptom response index，constipation increased from 7.9 on day 1 to 9.2 on day 3，while dyspnea increased from 2.7 on day 1 to 6.7 on day 14. Conclusion There is significant heterogeneity in the dynamic symptom changes after discharge among daytime lung cancer surgery patients. Medical and nursing staff can formulate targeted care strategies based on differences in patient characteristics across the trajectory groups and changes in the mean symptom response index for individual symptoms，thereby improving patient rehabilitation and providing high-quality，whole-course nursing care.

Key words: Day Surgery, Lung Neoplasms, Postoperative Symptoms, Group-Based Trajectory Modeling, Nursing Care

HAN Nafei, AN Chuanbo, YUAN Huadi, LAN Meijuan, HE Hong, WU Xiaoyan, LIU Li, GAO Liyan, XIN Dingjie, XU Xiaolin. Study on the longitudinal change trajectory and influencing factors of symptoms in patients undergoing daytime lung cancer surgery after discharge[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(11): 1335-1341.

Figures/Tables 5

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References 30

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Study on the longitudinal change trajectory and influencing factors of symptoms in patients undergoing daytime lung cancer surgery after discharge

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