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

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2.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
3.	孙可欣, 郑荣寿, 张思维, 等. 2015 年中国分地区恶性肿瘤发病和死亡分析. 中国肿瘤, 2019, 28(1): 1-11.
4.	郭晓彤, 赫捷. 食管癌治疗现状及精准医学时代展望. 中华肿瘤杂志, 2016, 38(9): 641-645.
5.	霍小东, 于振涛. 多学科团队在食管癌诊断与治疗中的作用. 中国肿瘤临床, 2016, 43(12): 502-506.
6.	胡琰霞, 吴蓓雯, 李鹤成, 等. 食管癌术后症状的混合方法研究. 外科理论与实践, 2018, 23(3): 279-285.
7.	蔡清华, 郭锦, 陈燕. 食管癌患者症状群与生活质量的相关性分析. 癌症进展, 2016, 14(9): 913-916.
8.	韩芳, 李丽, 伊力亚尔·夏合丁, 等. 食管癌化疗患者术后症状群困扰及其对病患日常生活的影响. 新疆医科大学学报, 2017, 40(2): 156-159, 166.
9.	刘风侠, 康琳, 张瑞丽, 等. 食管癌患者放疗相关症状群的因素分析. 中华护理杂志, 2015, 50(5): 585-588.
10.	夏宏伟, 方秦模, 刘丽丽, 等. 食管癌根治术后化疗患者症状困扰与生活质量的关系. 中华现代护理杂志, 2016, 22(17): 2415-2418.
11.	吴晓丹, 蒋超南, 覃惠英, 等. 食管癌术后辅助化疗患者症状困扰与应对方式的相关性研究. 护理管理杂志, 2014, 14(2): 77-79.
12.	宋阳阳, 丁淳, 曾诗颖, 等. 食管癌患者术后症状群干预的研究进展. 中国护理管理, 2019, 19(1): 138-141.
13.	李楠楠, 吴静, 周洁. 癌症患者症状群纵向研究现状综述. 中华护理杂志, 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.	吴晓丹, 张美芬, 袁秀红, 等. 食管癌根治术后化疗患者症状及其影响因素的调查. 中华护理杂志, 2013, 48(11): 995-999.
17.	齐芳迎, 王小凤, 李洁. 食管癌患者放疗期间与放疗后症状困扰的调查分析. 中国实用护理杂志, 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.	邹小芳, 于书慧, 刘青. 老年患者吞咽困难评估的研究进展. 实用医学杂志, 2012, 8(3): 504-506.
21.	毛友生, 赫捷, 高树庚, 等. 我国食管癌外科治疗目前存在的热点争议与未来研究方向. 中华胃肠外科杂志, 2015, 9: 851-854.
22.	徐震壮, 吴小波, 纪勇, 等. VATS食管癌切除胸部淋巴结清扫术的效果及对术后生存质量的影响. 中华普外科手术学杂志(电子版), 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.	张卫, 耿小平, 章新琼, 等. 症状群管理: 症状管理的新视角. 医学与哲学(B), 2016, 37(2): 5-7, 19.
25.	刘俊峰. 食管癌食管胃结合部癌术后残余食管与胸腔胃的功能变化. 中华胸心血管外科杂志, 2012, 28(12): 755-758.
26.	于永魁, 马军, 魏秀峰, 等. 食管癌术后早期进食显著改善患者的" 疲劳/疼痛”型和" 吞咽困难”症状. 胃肠病学和肝病学杂志, 2019, 28(2): 179-182.
27.	黄智慧. 康复护理在甲状腺乳头状癌术后声音嘶哑患者中的应用. 中国实用护理杂志, 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. 孙可欣, 郑荣寿, 张思维, 等. 2015 年中国分地区恶性肿瘤发病和死亡分析. 中国肿瘤, 2019, 28(1): 1-11.
4. 郭晓彤, 赫捷. 食管癌治疗现状及精准医学时代展望. 中华肿瘤杂志, 2016, 38(9): 641-645.
5. 霍小东, 于振涛. 多学科团队在食管癌诊断与治疗中的作用. 中国肿瘤临床, 2016, 43(12): 502-506.
6. 胡琰霞, 吴蓓雯, 李鹤成, 等. 食管癌术后症状的混合方法研究. 外科理论与实践, 2018, 23(3): 279-285.
7. 蔡清华, 郭锦, 陈燕. 食管癌患者症状群与生活质量的相关性分析. 癌症进展, 2016, 14(9): 913-916.
8. 韩芳, 李丽, 伊力亚尔·夏合丁, 等. 食管癌化疗患者术后症状群困扰及其对病患日常生活的影响. 新疆医科大学学报, 2017, 40(2): 156-159, 166.
9. 刘风侠, 康琳, 张瑞丽, 等. 食管癌患者放疗相关症状群的因素分析. 中华护理杂志, 2015, 50(5): 585-588.
10. 夏宏伟, 方秦模, 刘丽丽, 等. 食管癌根治术后化疗患者症状困扰与生活质量的关系. 中华现代护理杂志, 2016, 22(17): 2415-2418.
11. 吴晓丹, 蒋超南, 覃惠英, 等. 食管癌术后辅助化疗患者症状困扰与应对方式的相关性研究. 护理管理杂志, 2014, 14(2): 77-79.
12. 宋阳阳, 丁淳, 曾诗颖, 等. 食管癌患者术后症状群干预的研究进展. 中国护理管理, 2019, 19(1): 138-141.
13. 李楠楠, 吴静, 周洁. 癌症患者症状群纵向研究现状综述. 中华护理杂志, 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. 吴晓丹, 张美芬, 袁秀红, 等. 食管癌根治术后化疗患者症状及其影响因素的调查. 中华护理杂志, 2013, 48(11): 995-999.
17. 齐芳迎, 王小凤, 李洁. 食管癌患者放疗期间与放疗后症状困扰的调查分析. 中国实用护理杂志, 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. 邹小芳, 于书慧, 刘青. 老年患者吞咽困难评估的研究进展. 实用医学杂志, 2012, 8(3): 504-506.
21. 毛友生, 赫捷, 高树庚, 等. 我国食管癌外科治疗目前存在的热点争议与未来研究方向. 中华胃肠外科杂志, 2015, 9: 851-854.
22. 徐震壮, 吴小波, 纪勇, 等. VATS食管癌切除胸部淋巴结清扫术的效果及对术后生存质量的影响. 中华普外科手术学杂志(电子版), 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. 张卫, 耿小平, 章新琼, 等. 症状群管理: 症状管理的新视角. 医学与哲学(B), 2016, 37(2): 5-7, 19.
25. 刘俊峰. 食管癌食管胃结合部癌术后残余食管与胸腔胃的功能变化. 中华胸心血管外科杂志, 2012, 28(12): 755-758.
26. 于永魁, 马军, 魏秀峰, 等. 食管癌术后早期进食显著改善患者的" 疲劳/疼痛”型和" 吞咽困难”症状. 胃肠病学和肝病学杂志, 2019, 28(2): 179-182.
27. 黄智慧. 康复护理在甲状腺乳头状癌术后声音嘶哑患者中的应用. 中国实用护理杂志, 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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