摘要目的:探讨基于症状群的健康管理模式对肺癌微创手术出院患者的护理效果。方法:选取2019年4—8月上海市胸科医院肺癌微创手术出院后患者为研究对象，按照干预方法为对照组、试验组，干预时间1个月。对照组进行常规随访，试验组采用基于症状群管理的健康管理模式：根据探索因子分析法，提取出特征值>1的3个因子，因子载荷≥0.5的症状纳入症状群，基于症状群实施出院后护理，包括建立健康管理档案、发放肺癌症状群手册、健康宣教、患者交流管理。干预前后采用安德森症状评估表（中文版）评估患者的症状群评分，比较症状群对患者日常生活的干扰及对生活质量的影响。结果:共纳入研究对象85例，对照组40例（47.1%）、试验组45例（52.9%）。对照组男28例（70.0%），女12例（30.0%），年龄（60.2±6.5）岁，病程（8.0±2.0）个月，吸烟史21例（52.5%）。试验组男30例（66.7%），女15例（33.3%），年龄（60.6±6.8）岁，病程（7.9±2.1）个月，吸烟史22例（48.9%）。对照组与试验组年龄、性别、病程、吸烟史差异均无统计学意义（均 P>0.05）。干预前两组各症状因子载荷无明显差异，干预后对照组各症状因子载荷无明显变化，试验组各症状群因子载荷数目减少，干预后患者症状群中各症状较干预前减少。干预后的试验组症状群评分、症状群对日常生活的干扰总分均显著低于对照组［（32.4±10.3）比（44.3±11.5）分、（15.2±5.3）比（28.8±8.1）分］，生活质量评分显著高于对照组［（88.3±18.5）比（64.2±16.5）分］（均 P<0.05）。 结论:基于症状群管理的健康管理模式应用于肺癌患者微创手术出院后护理中能够改善患者的症状，减轻症状群对日常生活的影响，提高生活质量。

abstractsObjective:To explore the application effect of the health management mode based on symptom group management in the nursing of lung cancer patients after minimally invasive surgery.Methods:The lung cancer patients underwent minimally invasive surgery and were discharged from Shanghai Chest Hospital from April to August 2019 were selected as the study subjects. The patients were divided into control group and experimental group, with the intervention time of 1 month. Routine follow-up was carried out in the control group. The health management mode based on symptom group management was adopted in experimental group. According to the exploratory factor analysis method, three factors with characteristic value>1were extracted, and the symptoms with factor load≥0.5 were included in the symptom group, and post discharge nursing was carried out based on the symptom group, including establish health management archives, distribute symptom group manual, centralized teaching, WeChat communication, etc. Before and after nursing care, Anderson symptom evaluation form (Chinese version) was used to evaluate the symptom group score of patients and compare the interference of symptom group on daily life and the influence on quality of life.Results:A total of 40 cases (47.1%) in the control group and 45 cases (52.9%) in the experimental group were included. In the control group, 28 cases (70.0%) were male, 12 cases (30.0%) were female, the average age was (60.2±6.5) years, the average time of cancer was (8.0±2.0) months, and 21 cases (52.5%) had a history of smoking. In the experimental group, there were 30 (66.7%) males, 15 (33.3%) females, age (60.6±6.8), mean time of cancer (7.9±2.1) months, and 22 (48.9%) smokers. There was no significant difference in gender, age, average time of cancer and smoking history between the two groups (all P>0.05).There was no significant difference in factor load of those symptoms between the two groups before nursing, and there was no significant difference before and after nursing in the control group. After the intervention, the symptoms in the experimental group were less than before the intervention. The total scores of symptom group and disturbance of daily life in the experimental group were (32.4±10.3), (15.20±5.3), lower than those in the control group (44.3±11.5), (28.8±8.1), the quality of life score was (88.3±18.5), higher than that in the control group (64.2±16.5) (all P<0.05). Conclusion:The health management model based on symptom group management can improve the symptoms of patients with lung cancer after minimally invasive surgery, reduce the impact of symptom group on daily life and improve the quality of life.