目的 调查乳腺癌患者术后康复期症状发生情况,分析症状群特征及其影响因素,为制定针对性医疗干预提供依据。方法 选取2022年1月—2024年12月接受治疗的218例乳腺癌患者为研究对象。采用一般资料调查表和安德森症状评估量表进行评估,运用探索性因子分析提取症状群,并采用一般线性回归分析其影响因素。结果 乳腺癌患者术后康复期共提取出3个症状群,分别为情绪-睡眠症状群、胃肠-代谢症状群和神经-疼痛症状群。一般线性回归结果显示,年龄、美国东部肿瘤协作组（ECOG）评分、定期锻炼及术后化疗是情绪-睡眠症状群的影响因素;ECOG评分、定期锻炼及术后化疗是胃肠-代谢症状群的影响因素;合并慢性病、ECOG评分及术后放疗是神经-疼痛症状群的影响因素。结论 乳腺癌患者术后康复期存在多种并发症状,呈现明显的症状群特征。临床应针对不同症状群的影响因素制定科学、个体化的医疗干预策略,以促进患者术后康复与生活质量改善。
Objective To investigate the occurrence of symptoms of breast cancer patients during postoperative rehabilitation period, analyze the characteristics of symptom clusters and their influencing factors, and provide a basis for developing targeted medical interventions. Methods A total of 218 breast cancer patients treated at Yulin First People’s Hospital from January 2022 to December 2024 were enrolled. The General Information Questionnaire and the MD Anderson Symptom Inventory （MDASI） were used for assessment. Exploratory factor analysis was applied to identify symptom clusters, and general linear regression was conducted to analyze their influencing factors. Results Three symptom clusters were identified among the breast cancer patients during postoperative rehabilitation period： the emotional-sleep symptom cluster, the gastrointestinal-metabolic symptom cluster, and the neurological-pain symptom cluster. General linear regression analysis showed that age, Eastern Cooperative Oncology Group （ECOG） performance status scale score, regular exercise, and postoperative chemotherapy were influencing factors of the emotional-sleep symptom cluster; ECOG performance status scale score, regular exercise, and postoperative chemotherapy were influencing factors of the gastrointestinal-metabolic symptom cluster; and chronic disease comobidity, ECOG performance status scale score, and postoperative radiotherapy were influencing factors of the neurological-pain symptom cluster. Conclusion Breast cancer patients experience multiple complications during postoperative rehabilitation, showing distinct symptom cluster characteristics. Clinical care should focus on the influencing factors of different symptom clusters to develop evidence-based and individualized medical interventions that promote postoperative recovery and improve patients’ quality of life.
[1] Siegel RL, Kratzer TB, Giaquinto AN, et al.Cancer statistics, 2025[J]. CA Cancer J Clin, 2025, 75(1): 10-45.
[2] So WK, Law BM, Ng MS, et al.Symptom clusters experienced by breast cancer patients at various treatment stages: a systematic review[J]. Cancer Med, 2021, 10(8): 2531-2565.
[3] Renna ME, Shrout MR, Madison AA, et al.Distress disorder histories relate to greater physical symptoms among breast cancer patients and survivors: Findings across the cancer trajectory[J]. Int J Behav Med, 2023, 30(4): 463-472.
[4] Lu X, Geng W, Liu F, et al.Symptom clusters and sentinel symptoms in breast cancer survivors based on self-reported outcomes:a cross-sectional survey[J]. J Clin Nurs, 2025, 34(3): 1072-1080.
[5] 姚婉晴, 卢薇, 陈旦旦, 等. 乳腺癌患者辅助化疗期间症状群轨迹的纵向研究[J]. 肿瘤代谢与营养电子杂志, 2025, 12(2): 208-214.
[6] 夏碧莹, 张男, 陆艳, 等. 乳腺癌患者术前症状群特征的潜在剖面分析[J]. 上海护理, 2023, 23(12): 50-55.
[7] Han B, Ren S, Jin J, et al.Symptom burden and symptom clusters in patients with breast cancer undergoing endocrine therapy: a cross-sectional survey[J]. Support Care Cancer, 2025, 33(7): 598.
[8] 雷静, 李金花, 李旭英, 等. 乳腺癌患者化疗后居家期间症状群特征及影响因素研究[J]. 中国护理管理, 2023, 23(7): 1053-1058.
[9] Nielsen AWM, Lundorff M, Nielsen HM, et al.Symptom trajectories in breast cancer survivors: growth mixture analysis of patient-reported pain, fatigue, insomnia, breast and arm symptoms[J]. Acta Oncol, 2021, 60(12): 1659-1667.
[10] 张新春, 王义海, 陈玲, 等. 基于网络分析乳腺癌术后化疗患者症状群桥梁症状的横断面研究[J]. 现代临床护理, 2024, 23(8): 11-18.
[11] Liu X, Xia X, Hu F, et al.The mediation role of sleep quality in the relationship between cognitive decline and depression[J]. BMC Geriatr, 2022, 22(1): 178.
[12] Zhu Y, Wu T, Jiao Q, et al. Acute REM sleep deprivation alleviated depression-like behavior mediated by inhibiting VIP neurons in the mPFC[J]. Sci Adv, 2025, 11(37): eadx2666.
[13] Lorenzo-Gallego L, Arranz-Martin B, Romay-Barrero H, et al.Changes in pain sensitivity in treatment for breast cancer: a 12-month follow-Up case series[J]. Int J Environ Res Public Health, 2022, 19(7): 4055.
[14] 王利珍, 赖翠薇, 邱霓, 等. 乳腺癌术后初期患者症状群及前哨症状的调查研究[J]. 实用临床医药杂志, 2024, 28(20): 23-26.
[15] Han C, Li N, Wang X, et al.Sleep disorders in cancer: interactions and intrinsic links[J]. Front Oncol, 2025, 15(1): 1535442.
[16] 王泽鹏, 叶子, 袁姗姗. 宫颈癌患者放化疗期间症状群的影响因素[J]. 实用临床医药杂志, 2025, 29(10): 68-72.
[17] Dragoi CM, Nicolae AC, Ungurianu A, et al.Circadian rhythms, chrononutrition, physical training, and redox homeostasis-molecular mechanisms in human health[J]. Cells, 2024, 13(2): 138.
[18] 刘璐, 王亭亭, 李小静, 等. 维持性血液透析患者的症状群及其影响因素调查研究[J]. 海南医学, 2025, 36(14): 2087-2092.
[19] 艾小红, 李芳英, 王同玫, 等. 老年乳腺癌化疗患者消化道反应的影响因素分析[J]. 临床消化病杂志, 2024, 36(6): 395-398.
[20] Li B, Che L, Li H, et al.Peripheral blood immunoinflammatory biomarkers: prospective predictors of postoperative long-term survival and chronic postsurgical pain in breast cancer[J]. Front Immunol, 2025, 16(1): 1531639.
[21] 许长佳, 王莉莉, 伍焱, 等. 乳腺癌根治术患者术后上肢淋巴水肿发生的影响因素分析及预测模型的构建[J]. 保健医学研究与实践, 2025, 22(5): 78-83.
