胸腔镜肺癌术后患者咳嗽变化轨迹及影响因素研究OA
Study on the trajectory of cough changes and influencing factors in patients after thoracoscopic lung cancer surgery
目的 探讨胸腔镜肺癌术后患者咳嗽变化轨迹及影响因素,为制定肺癌患者术后延续性护理方案提供参考.方法 采用便利抽样法,选取2023年12月至2024年6月在浙江省某三级甲等医院接受胸腔镜肺癌手术的315例患者作为调查对象,在术后3周(T1)、术后8周(T2)、术后13周(T3)、术后18周(T4)及术后23周(T5)采用肺癌相关性咳嗽数字分级法评估量表对其进行调查.采用潜类别增长模型拟合咳嗽轨迹类型、多因素logistic回归分析不同咳嗽轨迹的影响因素.结果 283例胸腔镜肺癌术后患者全程参与5次调查.在T1～T5时间点,患者肺癌相关性咳嗽数字分级法评估量表评分分别为(2.94±1.46)分、(2.57±1.16)分、(1.95±0.99)分、(1.60±0.82)分、(1.32±0.73)分,分为"轻度咳嗽-持续维持组"214例(75.6%)和"中度咳嗽-缓慢下降组"69例(24.4%)2个潜在类别.回归分析结果显示,手术部位(OR=4.184)、负压引流球(OR=0.176)、留置引流管时间(OR=1.808)、接触刺激环境(OR=2.768)进入回归方程,差异有统计学意义(P<0.05).结论 胸腔镜肺癌术后患者咳嗽变化轨迹受手术部位、引流管类型、留置引流管时间、接触刺激环境的影响,医护人员可根据患者咳嗽变化轨迹的影响因素早期识别"中度咳嗽-缓慢下降组"的患者并制定相应干预措施,提供针对性的延续性护理,以提高治疗效果及患者术后生活质量.
Objective To explore the trajectory of cough changes and influencing factors in patients after thoracoscopic lung cancer surgery,and to provide a reference for developing postoperative continuous care programs for lung cancer pa-tients.Methods Using a convenience sampling method,315 patients who underwent thoracoscopic lung cancer surgery in a tertiary hospital in Zhejiang Province from December 2023 to June 2024 were selected as research subjects.The Lung Can-cer-Related Cough Numerical Rating Scale was used to assess patients at five time points,which were 3 weeks(T1),8 weeks(T2),13 weeks(T3),18 weeks(T4),and 23 weeks(T5)after surgery.The latent class growth model was applied to identify the categories of cough trajectory,and multivariate logistic regression was used to analyze the influencing factors of different cough trajectory categories.Results A total of 283 patients who underwent thoracoscopic lung cancer surgery completed all five surveys.At time points T1 to T5,the scores of the Lung Cancer-Related Cough Numerical Rating Scale were(2.94±1.46),(2.57±1.16),(1.95±0.99),(1.60±0.82),and(1.32±0.73),respectively.Two latent cough trajectory categories were identified,which were 214 cases(75.6%)in the"mild cough-persistent maintenance group"and 69 cases(24.4%)in the"moderate cough-slowly decline group".Regression analysis indicated that surgical site(OR=4.184),use of a negative pressure drainage bulb(OR=0.176),duration of drainage tube placement(OR=1.808),and ex-posure to irritating environments(OR=2.768)entered the regression equation,with statistically significant differences(P<0.05).Conclusion The trajectory of cough changes in patients after thoracoscopic lung cancer surgery is influenced by sur-gical site,type and duration of drainage tube placement,and exposure to irritating environments.Healthcare professionals should identify patients in the"moderate cough-slowly decline group"at an early stage based on these influencing factors of their cough change trajectory and develop corresponding intervention measures,providing targeted continuous care to im-prove treatment outcomes and patients'postoperative quality of life.
余协媛;李敏;闵伟伟;沈静妮;翟跃丽;苏艳光
湖州市中心医院,浙江 湖州 313000湖州市中心医院,浙江 湖州 313000湖州市中心医院,浙江 湖州 313000湖州市中心医院,浙江 湖州 313000湖州市中心医院,浙江 湖州 313000湖州市中心医院,浙江 湖州 313000
医药卫生
肺癌咳嗽变化轨迹影响因素
lung cancercoughtrajectory of changeinfluencing factors
《护理与康复》 2026 (1)
6-11,6
湖州市科技局公益性研究计划项目,编号2021GYB19
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