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中国癌症防治杂志

中国癌症防治杂志 ›› 2025, Vol. 17 ›› Issue (5): 590-597.doi: 10.3969/j.issn.1674-5671.2025.05.10

• 论著 • 上一篇    下一篇

乳腺癌患者卵巢功能抑制治疗期间的核心症状及症状群网络分析

  

  1. 上海交通大学医学院附属瑞金医院护理部；上海交通大学护理学院；上海交通大学医学院附属瑞金医院乳腺疾病诊治中心
  • 出版日期:2025-10-25 发布日期:2025-12-03
  • 通讯作者: 方琼 E-mail:jonesfang@sjtu.edu.cn
  • 基金资助:
    上海市健康科普人才能力提升专项项目（JKKPYL?2024?A06）；上海交通大学医学院附属瑞金医院护理科研基金项目[RJKH(Y)?2024?021）]

Network analysis of core symptoms and symptom clusters in breast cancer patients undergoing ovarian function suppression therapy

  • Online:2025-10-25 Published:2025-12-03

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摘要： 目的 探讨乳腺癌患者在卵巢功能抑制（ovarian function suppression，OFS）治疗期间的症状群、症状间关联性及核心症状，为精准症状管理提供理论依据。 方法 采用便利抽样法，选取上海交通大学医学院附属瑞金医院2023年10月至2024年7月接受OFS治疗的1 132例乳腺癌患者为研究对象。采用一般资料调查表、症状负担问卷进行调查，通过探索性因子分析提取症状群，并运用R语言构建症状网络，分析症状强度（rs）、紧密性（rc）及中介中心性（rb）指标。 结果 乳腺癌OFS患者最常见的症状包括潮热（98.1%）、焦虑情绪（97.9%）和烦躁（97.8%）等。共提取出10个症状群：心理类、骨骼肌肉类、性类、皮肤类、睡眠类、神经系统类、躯体类、血管舒缩类、阴道类和消化道类等症状群。症状群网络分析显示，强度排名前3位症状为阴道干涩（rs=1.265）、潮热（rs=1.232）和盗汗（rs=1.204），紧密性排名前3位症状为盗汗（rc=0.00210）、潮热（rc=0.00204）和肌肉痛（rc=0.00195），中介中心性排名前3位症状为盗汗（rb=93.000）、潮热（rb=77.000）和阴道干涩（rb =63.000）。 结论 阴道干涩、潮热、盗汗是乳腺癌OFS患者症状网络中的核心症状。建议医护人员密切关注这些症状的变化，结合症状群特征及核心症状在症状网络中的影响力实施针对性干预，以提高症状管理效果。

关键词: 乳腺癌, 卵巢功能抑制, 症状群, 核心症状, 症状网络

Abstract: Objective To investigate the symptom clusters, interrelationships among symptoms, and core symptoms in breast cancer patients undergoing ovarian function suppression (OFS) therapy, with the objective of establishing a theoretical foundation for precise symptom management. Methods Convenience sampling was used to select 1,132 breast cancer patients who received OFS therapy at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from October 2023 to July 2024. General information questionnaire and symptom burden scale were used for the investigation. Exploratory factor analysis was employed to identify symptom clusters, and R language was used to construct the symptom network to analyze indicators of symptom strength (rs), closeness (rc), and betweenness (rb). Results The most common symptoms among breast cancer patients undergoing OFS therapy were hot flashes（98.1%）, anxiety mood （97.9%）, and irritability （97.8%）. Ten distinct symptom clusters were identified: psychological, musculoskeletal, sexual, skin, sleep, nervous, somatic, vasomotor, vaginal, and gastrointestinal. Symptom network analysis showed that the top three symptoms by strength were vaginal dryness (rs=1.265), hot flashes (rs=1.232), and night sweats (rs=1.204); the top three by closeness were night sweats (rc=0.00210), hot flashes (rc=0.00204), and myalgia (rc=0.00195); and the top three by betweenness were night sweats (rb=93.000), hot flashes (rb=77.000), and vaginal dryness (rb=63.000).  Conclusions Vaginal dryness, hot flashes, and night sweats are identified as core symptoms within the symptom network of breast cancer patients undergoing OFS therapy. It is recommended that healthcare professionals closely monitor the changes in these symptoms and implement targeted interventions based on the characteristics of symptom clusters and the network influence of core symptoms, so as to enhance symptom management outcomes.

Key words: Breast cancer, Ovarian function suppression, Symptom clusters, Core symptoms, Symptom network

中图分类号: 

  • R737.9