关键词: 胃肿瘤, 肠肿瘤, 放化疗,辅助, 症状和体征

Abstract: Objective　To explore the symptoms and symptom clusters predicting the physical and psychological status of patients with gastroenteric tumor after first adjuvant chemotherapy,to develop a strategy for the management of symptoms.Methods　A cross-sectional study was conducted among patients with gastroenteric tumor who went to the Second Affiliated Hospital of Zhengzhou University from August 2014 to December 2015.The memorial symptom assessment scale（MSAS） was used to evaluate the symptoms of patients after first adjuvant chemotherapy.The general data and the incidence of symptoms were expressed by relative number,and the severity of each symptom was described by （x±s）;Principal component analysis was used to extract symptom clusters.Results　A total of 150 questionnaires were distributed，143 were effective，the effective recovery rate was 95.3%.After first adjuvant chemotherapy,the most prevalent symptoms of gastroenteric tumor patients were lack of energy/fatigue〔60.1%（86/143）〕,pain〔53.8%（77/143）〕,cough〔48.3%（69/143）〕,lack of appetite〔44.8%（64/143）〕.Prevalence of 20 symptoms was ≥20.0%，the principle component analysis was used to analyse these symptoms,and 5 symptom clusters had been found,the cumulative variance contribution rate was 51.2%,the 5 symptom clusters were the gastrointestinal symptom cluster（nausea,vomit and ventosity）,a limb-related cluster（numbness/stabbing pain of hand/foot,swelling of arm/leg）,a body image change cluster（lipsotrichia,feel "not look like oneself"）,a energy deficiency symptom cluster（loss of weight,dysphagia,lack of appetite,vomit,pain）,a emotion-related symptom cluster（worry,giddiness,fidget,feel sad,nervous,impaired concentration,lack of energy/fatigue,incline to sleep）.The variance contribution rate of each cluster was 10.3%，5.6%，10.9%，11.8%，and 12.6% respectively,and the Cronbach’s α coefficients of each cluster was 0.70，0.43，0.73，0.85，and 0.87 respectively.Conclusion　The gastrointestinal symptom cluster,a limb-related cluster,a body image change cluster,a energy deficiency symptom cluster,a emotion-related symptom cluster are the main symptom clusters of patients with gastroenteric tumor after first adjuvant chemotherapy.These symptom clusters can provide scientific bases for exploring effective and practical evaluation of symptoms and intervention model among patients with gastroenteric tumor.

Key words: Stomach neoplasms, Intestinal neoplasms, Chemoradiotherapy,adjuvant, Symptoms & signs