关键词: 食管癌, 手术后, 症状群, 影响因素

Abstract: Objective To investigate the symptoms of patients with esophageal cancer 3 months after operation in Zhengzhou and explore the types of symptoms, analyze the influencing factors of postoperative symptoms, and guide the formulation of symptom management and intervention measures. Methods Patients with esophageal cancer who underwent surgery in the Fifth Affiliated Hospital of Zhengzhou University from January 1, 2018, to December 31, 2020, were included in the study. Based on the Chinese Version of the M.D. Anderson Symptom Inventory （MDASI-C）, a self-made questionnaire was used to evaluate the severity of postoperative symptoms of patients who completed the follow-up visit as required 3 months after the operation. Exploratory factor analysis method was used to explore the type and composition of symptom groups. Univariate and multivariate linear regression analysis methods were used to analyze the influencing factors of symptom groups of patients with esophageal cancer 3 months after operation in Zhengzhou. Results The complete data of 293 patients with esophageal cancer were collected in the study. The highest incidence of symptoms was anorexia （95.90%）, fatigue （89.42%）, reflux （79.86%）, and eating difficulty （78.16%）. The most severe symptoms was fatigue （6.05±1.49）, reflux （5.92±1.62）, anorexia （5.87±1.53）, and disturbed sleep （5.56±1.38）. Three symptom groups were obtained by exploratory factor analysis, which were gastrointestinal related symptom group, fatigue-related symptom group, and eating difficulty-pain symptom group, the symptom scores were （20.19±3.56）, （18.24±3.10）, and （23.92±4.07） points, respectively. Univariate and multivariate linear regression analysis showed that age （β’=0.361）, esophageal cancer staging （β’=0.152）, therapeutic modalities （β’=0.378）, and anastomotic site （β’=-0.089） were the influencing factors of gastrointestinal related symptoms; gender （ β’=0.086 ）, age （ β’=2.011 ）, esophageal cancer staging （ β’=1.562 ）, and therapeutic modalities （ β’=0.104 ） were the influencing factors of fatigue-related symptoms; gender （ β’=1.127 ）, esophageal cancer staging （ β’=0.413 ）, therapeutic modalities （ β’=0.459 ）, and anastomotic site （β’=0.518 ） were the influencing factors of eating difficulty-pain symptoms. Conclusion Three months after surgery, patients with esophageal cancer in Zhengzhou have gastrointestinal-related symptoms, fatigue-related symptoms, and eating difficulty-pain symptoms. The occurrence of symptoms is affected by gender, age, esophageal cancer staging, therapeutic modalities, and anastomotic site. It is necessary to establish efficient and individualized management and intervention strategies according to symptoms and their influencing factors.

Key words: Esophageal cancer, Postoperative, Symptom group, Influencing factor