【摘要】 目的 构建中老年宫颈癌同步放化疗患者的症状网络，探索核心症状，并比较不同亚组间症状网络的差异。方法 2023年6月—2024年5月，采用便利抽样法选取安徽省某三级甲等医院339例中老年宫颈癌同步放化疗患者为研究对象。采用一般资料调查表、中晚期宫颈癌同步放化疗病人症状评估量表进行调查。使用R语言构建症状网络，分析中心性指标，确定核心症状；经倾向性评分匹配后，使用网络比较测试比较不同肿瘤分期症状网络特征的差异。结果 中老年宫颈癌同步放化疗患者疲乏的发生率(97%)和严重程度[3.00(3.00,4.00)]最高。网络分析结果显示，中老年宫颈癌同步放化疗患者悲伤的强度最大(r_s=1.291)。不同肿瘤分期(Ⅰ、Ⅱ期和Ⅲ、Ⅳ期)的网络结构(P=0.750)和全局强度(P=0.086)差异无统计学意义；Ⅲ、Ⅳ期患者症状网络中肠道症状和泌尿系统症状、精神紧张与害怕有性行为间存在额外联系，精神紧张、里急后重、全身或局部疼痛的症状强度高于Ⅰ、Ⅱ期患者(P<0.05)。结论 悲伤是中老年宫颈癌同步放化疗患者的核心症状，肿瘤Ⅰ、Ⅱ期与Ⅲ、Ⅳ期患者的症状网络特征总体相似，Ⅲ、Ⅳ期患者部分症状关联性和强度更大。更多还原

【Abstract】 Objective To construct the symptom network of middle-aged and elderly cervical cancer patients with concurrent chemoradiotherapy, explore the core symptoms, and compare the difference of symptom network among different subgroups.Methods From June 2023 to May 2024, 339 middle-aged and elderly patients with concurrent chemoradiation of cervical cancer in a tertiary A hospital in Anhui province were selected by convenient sampling method as the study objects, and were investigated by general data questionnaire and symptom assessment scale for patients with advanced cervical cancer undergoing concurrent chemoradiotherapy. Symptom network was constructed with R language to analyze the central indicators and determine the core symptoms, and after matching the propensity score, network comparison test was used to compare the differences in symptom network characteristics of different tumor stages. Results The incidence of fatigue(97%) and severity [3.00(3.00, 4.00)] were the highest in middle-aged and elderly patients with concurrent chemoradiotherapy for cervical cancer. The results of network analysis showed that the intensity of grief was the highest in middle-aged and elderly patients with concurrent radiotherapy and chemotherapy(rs=1.291). There was no significant difference in network structure(P=0.75) and global intensity(P=0.086) among different tumor stages(Ⅰ, Ⅱand Ⅲ, Ⅳ). In the symptom network of patients in stage Ⅲ and Ⅳ, there was an additional relationship between intestinal symptoms and urinary symptoms, nervous tension and fear of sexual activity, and the symptom intensity of nervous tension, posterior tachycardia, and general or local pain was higher than that of patients in stage Ⅰ and Ⅱ(P<0.05). Conclusion Sadness is the core symptom of middle-aged and elderly cervical cancer patients with concurrent chemoradiotherapy. The symptom network characteristics of tumor stage Ⅰ,Ⅱ and Ⅲ,Ⅳ patients are generally similar, and the correlation and intensity of some symptoms in Ⅲ and Ⅳ patients are greater.更多还原