The symptoms and influencing factors of patients with esophageal cancer in postoperative rehabilitation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

MIAO Yan , XIE Qin , LI Yaling , LUO Chunyan , LENG Xuefeng ,  HAN Yongtao

Department of Thoracic Surgery, Sichuan Cancer Hospital & Research Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, P.R. China;

Corresponding?author：

HAN Yongtao, Email: hanyongt@aliyun.com

Keywords：

Esophageal cancer; surgery; rehabilitation; symptoms

DOI：

10.7507/1007-4848.201905061

Video：

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Objective To analyze the symptom characteristics and influencing factors in order to provide reference for symptom management of patients with esophageal cancer after operation.Methods A total of 216 esophageal cancer patients, including 180 males and 36 females with an average age of 63.7±8.3 years, who underwent surgical operation in our hospital from March to October 2018 were recruited and investigated with self-designed symptom questionnaire at 1 month after surgery.Results The top five symptoms were acid reflux (48.6%), cough (42.6%), dysphagia (40.7%), hoarseness (12.0%), and diarrhea (11.6%). Women were more prone to acid reflux (OR=2.053), fatigue (OR=1.932), chest pain (OR=3.681), sleep disturbance (OR=2.419), abdominal pain (OR=3.882), nausea (OR=3.014) and vomiting (OR=2.505). Patients over 60 years were more prone to dysphagia (OR=2.274). Patients with lower thoracic esophageal cancer had a higher incidence of dysphagia compared with patients with carcinoma of esophagogastric junction (OR=0.326). Patients who had neoadjuvant chemotherapy were more likely to suffer acid reflux (OR=1.594). Open surgery (OR=3.681) and neoadjuvant radiotherapy (OR=2.495) were the risk factors of chest pain.Conclusion There are many symptoms in patients with esophageal cancer after operation, and the occurrence of symptoms is closely related to gender, age, tumor location, surgical procedure and neoadjuvant chemoradiotherapy.

Citation： MIAO Yan, XIE Qin, LI Yaling, LUO Chunyan, LENG Xuefeng, HAN Yongtao. The symptoms and influencing factors of patients with esophageal cancer in postoperative rehabilitation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(1): 52-56. doi: 10.7507/1007-4848.201905061 Copy

1.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
3.	孫可欣, 鄭榮壽, 張思維, 等. 2015 年中國分地區惡性腫瘤發病和死亡分析. 中國腫瘤, 2019, 28(1): 1-11.
4.	郭曉彤, 赫捷. 食管癌治療現狀及精準醫學時代展望. 中華腫瘤雜志, 2016, 38(9): 641-645.
5.	霍小東, 于振濤. 多學科團隊在食管癌診斷與治療中的作用. 中國腫瘤臨床, 2016, 43(12): 502-506.
6.	胡琰霞, 吳蓓雯, 李鶴成, 等. 食管癌術后癥狀的混合方法研究. 外科理論與實踐, 2018, 23(3): 279-285.
7.	蔡清華, 郭錦, 陳燕. 食管癌患者癥狀群與生活質量的相關性分析. 癌癥進展, 2016, 14(9): 913-916.
8.	韓芳, 李麗, 伊力亞爾·夏合丁, 等. 食管癌化療患者術后癥狀群困擾及其對病患日常生活的影響. 新疆醫科大學學報, 2017, 40(2): 156-159, 166.
9.	劉風俠, 康琳, 張瑞麗, 等. 食管癌患者放療相關癥狀群的因素分析. 中華護理雜志, 2015, 50(5): 585-588.
10.	夏宏偉, 方秦模, 劉麗麗, 等. 食管癌根治術后化療患者癥狀困擾與生活質量的關系. 中華現代護理雜志, 2016, 22(17): 2415-2418.
11.	吳曉丹, 蔣超南, 覃惠英, 等. 食管癌術后輔助化療患者癥狀困擾與應對方式的相關性研究. 護理管理雜志, 2014, 14(2): 77-79.
12.	宋陽陽, 丁淳, 曾詩穎, 等. 食管癌患者術后癥狀群干預的研究進展. 中國護理管理, 2019, 19(1): 138-141.
13.	李楠楠, 吳靜, 周潔. 癌癥患者癥狀群縱向研究現狀綜述. 中華護理雜志, 2017, 52(1): 24-28.
14.	Jacobs M, Macefield RC, Elbers RG, et al. Meta-analysis shows clinically relevant and long-lasting deterioration in health-related quality of life after esophageal cancer surgery. Qual Life Res, 2014, 23(4): 1155-1176.
15.	Ginex P, Thom B, Jingeleski M, et al. Patterns of symptoms following surgery for esophageal cancer. Oncol Nurs Forum, 2013, 40(3): E101-E107.
16.	吳曉丹, 張美芬, 袁秀紅, 等. 食管癌根治術后化療患者癥狀及其影響因素的調查. 中華護理雜志, 2013, 48(11): 995-999.
17.	齊芳迎, 王小鳳, 李潔. 食管癌患者放療期間與放療后癥狀困擾的調查分析. 中國實用護理雜志, 2013, 29(12): 38-40.
18.	Akin S, Can G, Aydiner A, et al. Quality of life, symptom experience and distress of lung cancer patients undergoing chemotherapy. Eur J Oncol Nurs, 2010, 14(5): 400-409.
19.	Ney DM, Weiss JM, Kind AJ, et al. Senescent swallowing: impact, strategies, and interventions. Nutr Clin Pract, 2009, 24(3): 395-413.
20.	鄒小芳, 于書慧, 劉青. 老年患者吞咽困難評估的研究進展. 實用醫學雜志, 2012, 8(3): 504-506.
21.	毛友生, 赫捷, 高樹庚, 等. 我國食管癌外科治療目前存在的熱點爭議與未來研究方向. 中華胃腸外科雜志, 2015, 9: 851-854.
22.	徐震壯, 吳小波, 紀勇, 等. VATS食管癌切除胸部淋巴結清掃術的效果及對術后生存質量的影響. 中華普外科手術學雜志(電子版), 2019, 13(1): 33-36.
23.	Mariette C, Dahan L, Mornex F, et al. Surgery alone versus chemoradiotherapy followed by surgery for stage Ⅰ and Ⅱ esophageal cancer: final analysis of randomized controlled phase Ⅲ trial FFCD 9901. J Clin Oncol, 2014, 32(23): 2416-2422.
24.	張衛, 耿小平, 章新瓊, 等. 癥狀群管理: 癥狀管理的新視角. 醫學與哲學(B), 2016, 37(2): 5-7, 19.
25.	劉俊峰. 食管癌食管胃結合部癌術后殘余食管與胸腔胃的功能變化. 中華胸心血管外科雜志, 2012, 28(12): 755-758.
26.	于永魁, 馬軍, 魏秀峰, 等. 食管癌術后早期進食顯著改善患者的" 疲勞/疼痛”型和" 吞咽困難”癥狀. 胃腸病學和肝病學雜志, 2019, 28(2): 179-182.
27.	黃智慧. 康復護理在甲狀腺乳頭狀癌術后聲音嘶啞患者中的應用. 中國實用護理雜志, 2012, 28(11): 32-33.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
3. 孫可欣, 鄭榮壽, 張思維, 等. 2015 年中國分地區惡性腫瘤發病和死亡分析. 中國腫瘤, 2019, 28(1): 1-11.
4. 郭曉彤, 赫捷. 食管癌治療現狀及精準醫學時代展望. 中華腫瘤雜志, 2016, 38(9): 641-645.
5. 霍小東, 于振濤. 多學科團隊在食管癌診斷與治療中的作用. 中國腫瘤臨床, 2016, 43(12): 502-506.
6. 胡琰霞, 吳蓓雯, 李鶴成, 等. 食管癌術后癥狀的混合方法研究. 外科理論與實踐, 2018, 23(3): 279-285.
7. 蔡清華, 郭錦, 陳燕. 食管癌患者癥狀群與生活質量的相關性分析. 癌癥進展, 2016, 14(9): 913-916.
8. 韓芳, 李麗, 伊力亞爾·夏合丁, 等. 食管癌化療患者術后癥狀群困擾及其對病患日常生活的影響. 新疆醫科大學學報, 2017, 40(2): 156-159, 166.
9. 劉風俠, 康琳, 張瑞麗, 等. 食管癌患者放療相關癥狀群的因素分析. 中華護理雜志, 2015, 50(5): 585-588.
10. 夏宏偉, 方秦模, 劉麗麗, 等. 食管癌根治術后化療患者癥狀困擾與生活質量的關系. 中華現代護理雜志, 2016, 22(17): 2415-2418.
11. 吳曉丹, 蔣超南, 覃惠英, 等. 食管癌術后輔助化療患者癥狀困擾與應對方式的相關性研究. 護理管理雜志, 2014, 14(2): 77-79.
12. 宋陽陽, 丁淳, 曾詩穎, 等. 食管癌患者術后癥狀群干預的研究進展. 中國護理管理, 2019, 19(1): 138-141.
13. 李楠楠, 吳靜, 周潔. 癌癥患者癥狀群縱向研究現狀綜述. 中華護理雜志, 2017, 52(1): 24-28.
14. Jacobs M, Macefield RC, Elbers RG, et al. Meta-analysis shows clinically relevant and long-lasting deterioration in health-related quality of life after esophageal cancer surgery. Qual Life Res, 2014, 23(4): 1155-1176.
15. Ginex P, Thom B, Jingeleski M, et al. Patterns of symptoms following surgery for esophageal cancer. Oncol Nurs Forum, 2013, 40(3): E101-E107.
16. 吳曉丹, 張美芬, 袁秀紅, 等. 食管癌根治術后化療患者癥狀及其影響因素的調查. 中華護理雜志, 2013, 48(11): 995-999.
17. 齊芳迎, 王小鳳, 李潔. 食管癌患者放療期間與放療后癥狀困擾的調查分析. 中國實用護理雜志, 2013, 29(12): 38-40.
18. Akin S, Can G, Aydiner A, et al. Quality of life, symptom experience and distress of lung cancer patients undergoing chemotherapy. Eur J Oncol Nurs, 2010, 14(5): 400-409.
19. Ney DM, Weiss JM, Kind AJ, et al. Senescent swallowing: impact, strategies, and interventions. Nutr Clin Pract, 2009, 24(3): 395-413.
20. 鄒小芳, 于書慧, 劉青. 老年患者吞咽困難評估的研究進展. 實用醫學雜志, 2012, 8(3): 504-506.
21. 毛友生, 赫捷, 高樹庚, 等. 我國食管癌外科治療目前存在的熱點爭議與未來研究方向. 中華胃腸外科雜志, 2015, 9: 851-854.
22. 徐震壯, 吳小波, 紀勇, 等. VATS食管癌切除胸部淋巴結清掃術的效果及對術后生存質量的影響. 中華普外科手術學雜志(電子版), 2019, 13(1): 33-36.
23. Mariette C, Dahan L, Mornex F, et al. Surgery alone versus chemoradiotherapy followed by surgery for stage Ⅰ and Ⅱ esophageal cancer: final analysis of randomized controlled phase Ⅲ trial FFCD 9901. J Clin Oncol, 2014, 32(23): 2416-2422.
24. 張衛, 耿小平, 章新瓊, 等. 癥狀群管理: 癥狀管理的新視角. 醫學與哲學(B), 2016, 37(2): 5-7, 19.
25. 劉俊峰. 食管癌食管胃結合部癌術后殘余食管與胸腔胃的功能變化. 中華胸心血管外科雜志, 2012, 28(12): 755-758.
26. 于永魁, 馬軍, 魏秀峰, 等. 食管癌術后早期進食顯著改善患者的" 疲勞/疼痛”型和" 吞咽困難”癥狀. 胃腸病學和肝病學雜志, 2019, 28(2): 179-182.
27. 黃智慧. 康復護理在甲狀腺乳頭狀癌術后聲音嘶啞患者中的應用. 中國實用護理雜志, 2012, 28(11): 32-33.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

The symptoms and influencing factors of patients with esophageal cancer in postoperative rehabilitation

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