摘要目的:探讨基于症状管理理论（SMT）的护理干预对原发性肝癌患者术后腹胀症状的干预效果。方法:选取2016年5月至2019年5月温州医科大学附属第二医院80例原发性肝细胞癌患者，按照入院时间分为试验组和对照组各40例。对照组给予常规术后护理，试验组在常规护理基础上实施基于SMT的护理干预。记录2组患者首次排便时间和首次排气时间，术后第1、3、7天评价患者腹胀严重程度，采用原发性肝癌特异性症状模块（TSM-PLC）评价患者症状困扰程度。结果:试验组首次排气时间、首次排便时间分别为（69.08 ± 11.44）、（78.80 ± 15.54） h，明显少于对照组的（76.03 ± 12.26）、（86.03 ± 13.48） h，差异有统计学意义（ t=2.62、2.22，均 P<0.05）。术后第3、7天，试验组腹胀症状明显轻于对照组，差异有统计学意义（ Z=2.31、2.34，均 P<0.05）。术后第7天，试验组TSM-PLC量表中腹胀症状、消瘦症状、发热症状得分分别为（1.80 ± 0.28）、（0.76 ± 0.21）、（0.48 ± 0.19）分，明显低于对照组的（2.16 ± 0.31）、（0.93 ± 0.25）、（0.74 ± 0.20）分，差异有统计学意义（ t=5.38、3.27、5.90， P<0.05）。 结论:基于症状管理理论的护理干预可促进原发性肝细胞癌患者术后胃肠道功能恢复，减轻患者术后腹胀症状困扰。

abstractsObjective:To investigate the effect of symptom management theory(SMT)-based nursing care for the prevention of postoperative abdominal distension in patients with primary hepatocellular carcinoma.Methods:A total of 80 primary hepatocellular carcinoma patients in the Second Affiliated Hospital of Wenzhou Medical University from May 2016 to May 2019 were assigned to the experimental group and the control group according to the admission time, there were 40 cases in each group. The patients in the control group received routine postoperative nursing care, while the patients in the experimental group added SMT-based intervention. The postoperative first exhaust time and defecation time were recorded; the abdominal distension degree after 1, 3, 7 days of surgery were evaluated. In addition, the symptom distress was assessed by The Symptom Module Specific to Primary Liver Cancer (TSM-PLC).Results:The postoperative first exhaust time and defecation time were (69.08±11.44), (78.80±15.54) h in the experimental group, which were significantly lower than those in the control group (76.03±12.26), (86.03±13.48) h, the differences were statistically significant ( t=2.62, 2.22, both P<0.05). After 3, 7 days of surgery, the abdominal distension degrees were significantly alleviated in the experimental group compared to the control group, the differences were statistically significant ( Z =2.31, 2.34, both P<0.05). After 7 days of surgery, the abdominal distension, weight loss, fever symptom scores in TSM-PLC were 1.80±0.28, 0.76±0.21, 0.48±0.19 in the experimental group, which were significantly lower than those in the control group 2.16±0.31, 0.93±0.25, 0.74±0.20, the differences were statistically significant ( t=5.38, 3.27, 5.90, all P<0.05). Conclusions:SMT-based intervention can promote the recovery of postoperative gastrointestinal function and alleviate abdominal distension symptom distress of patients with primary hepatocellular carcinoma.