目的 探讨头颈部肿瘤（head and neck cancer,HNC）患者放疗期间衰弱变化的轨迹及其影响因素，为临床护理人员管理衰弱提供数据支持和理论参考。方法 2023年4-12月，采用便利抽样法选取在长沙市某三级甲等医院接受放疗的202例HNC患者为研究对象，使用一般资料及疾病资料调查表、日常生活能力评定量表（Activity of Daily Living Scale,ADL）、阿森斯失眠量表（Athens Insomnia Scale,AIS）、蒂尔堡衰弱量表（Tilburg Frailty Indicator,TFI）对其放疗前、放疗第3周末及放疗毕的衰弱情况进行调查。使用潜在类别增长模型识别患者衰弱的变化轨迹，并采用二元Logistic回归分析轨迹的影响因素。结果 202例患者，识别出2类衰弱变化轨迹，分别为“低水平缓慢上升组（54.50%）”和“高水平快速上升组（45.50%）”；年龄、体质量指数（body mass index,BMI）、治疗方式、日常生活能力和失眠是HNC患者放疗期间衰弱变化轨迹的影响因素（均P＜0.05）。结论 HNC患者放疗期间衰弱变化轨迹呈上升趋势，存在异质性；临床护理人员应根据衰弱变化轨迹实施精准化干预措施。

Objective To investigate the trajectories of frailty and their influencing factors in head and neck cancer(HNC) patients undergoing radiotherapy,thereby providing data support and a theoretical framework for clinical frailty management in nursing practice.Methods From April to December 2023,202 HNC patients receiving radiotherapy at a tertiary A hospital in Changsha were conveniently sampled.Data were collected using the General Information Questionnaire,Activity of Daily Living Scale (ADL),Athens Insomnia Scale (AIS),and Tilburg Frailty Indicator (TFI) at three time points: before radiotherapy, at the end of the third week of radiotherapy, and upon completion of radiotherapypre-radiotherapy,3 weeks’ post-radiotherapy initiation,and post-radiotherapy completion.Latent class growth modeling identified frailty trajectories,and binary logistic regression was used to analyze influencing factors.Results Two distinct frailty trajectories were identified:a low-level gradual increase group (54.50%) and a high-level rapid increase group (45.50%).Key influencing factors included age,body mass index (BMI),treatment modality,self-care ability,and insomnia.Conclusions Frailty trajectories during radiotherapy in HNC patients show increasing trends with heterogeneity.Clinical nurses should implement precision interventions tailored to different frailty trajectories.

R473.73

湖南省自然科学基金（2024JJ6689）