目的 调查肺癌氩氦刀冷冻消融患者围术期症状群及前哨症状动态变化，为动态监测与管理症状群提供依据。 方法 便利抽样选取厦门某三级甲等医院肿瘤内科行氩氦刀冷冻消融治疗的155例肺癌患者为调查对象。在术前1~2 d和术后2~3 d，采用一般情况调查表、安德森症状评估量表-肺癌模块进行调查，采用主成分分析提取症状群，通过Apriori建模识别前哨症状。 结果 术前肺癌患者主要存在消化道症状群、病感症状群、食欲-呼吸症状群、胸部-情感症状群，其前哨症状分别为无明确前哨症状、疼痛、食欲下降、胸闷/气短/悲伤感/体重下降；术后主要存在病感症状群、神经-胸部感觉症状群、呼吸道症状群、情感-食欲-睡眠障碍症状群，其前哨症状分别为疼痛/气促、无明确前哨症状、体重下降、食欲下降/悲伤感/睡眠不安。 结论 肺癌氩氦刀冷冻消融治疗患者围术期存在动态变化的症状群及前哨症状，护理人员应及时、动态、有效评估患者症状，通过前哨症状的预警，预防与减缓症状群发生、发展，改善患者生活质量。

Objective To investigate the perioperative symptom clusters and sentinel symptoms in patients undergoing lung cancer argon-helium cryoablation treatment,and to provide a foundation for dynamically monitoring and managing symptom clusters. Methods A total of 155 lung cancer patients undergoing argon-helium cryoablation treatment were selected from Department of Oncology in a tertiary A hospital in Xiamen by the convenience sampling method.The investigation was conducted using a general condition questionnaire and the M.D.Anderson Symptom Inventory-Lung Cancer Module,administered 1~2 d before surgery and 2~3 d after surgery.Principal component analysis was used to extract symptom clusters,and Apriori modeling was used to identify sentinel symptoms. Results Preoperatively,lung cancer patients exhibited 4 symptom clusters:gastrointestinal symptoms,general malaise symptoms,appetite-respiratory symptoms,and chest-emotion symptoms.The sentinel symptoms were no specific sentinel symptoms,pain,reduced appetite,and chest tightness/shortness of breath/sadness/weight loss.Postoperatively,the main symptom clusters observed were general malaise symptoms,neuro-chest sensation symptoms,respiratory symptoms,and emotion-appetite-sleep disturbance symptoms.The sentinel symptoms were pain/dyspnea,no specific prodromal symptoms,weight loss,and reduced appetite/sadness/restlessness. Conclusions Lung cancer patients undergoing argon-helium cryoablation treatment exhibit dynamically changing symptom clusters and sentinel symptoms during the perioperative period.Healthcare professionals should timely,dynamically,and effectively assess patients’ symptoms.Through early warning with sentinel symptoms,the occurrence and progression of symptom clusters can be prevented and alleviated,thereby improving patients’ quality of life.

R473.56

2021年度广西高校中青年教师科研基础能力提升项目（2021KY1363)；2023年度广西壮族自治区卫生健康委西医类自筹经费科研课题（Z-A20231033）