目的 通过网络分析探究老年脑卒中患者多维症状网络，识别核心症状并分析多维症状的影响因素，为制订精准症状管理提供依据。方法 2024年1-5月，采用便利抽样法选取安徽省4所三级甲等医院收治的500例老年脑卒中患者为研究对象，采用一般资料调查表、脑卒中症状体验量表（stroke patients’ symptom experience scale,Stroke-SES）、多维健康心理控制源量表（multidimensional health locus of control，MHLC）、简易疾病感知问卷（brief illness perception questionnaire,BIPQ）对其进行调查。通过R语言构建症状网络并分析中心性指标，采用单因素分析、相关分析及多元线性回归分析探讨多维症状的影响因素。结果 老年脑卒中患者多维症状发生率为19.00%~94.60%。症状网络分析显示，“自理能力下降”强度中心性和预期影响均最高。多元线性回归分析显示，身体活动水平、健康内部控制、健康机遇控制、疾病感知是症状严重程度的影响因素（均P＜0.01），解释总变异的63.24%。结论 自理能力下降是老年脑卒中患者多维症状网络中的核心症状，受多重因素影响；医护人员可基于核心症状及其相关影响因素制订精准干预措施，以提升症状管理效能。

Objective To explore the multidimensional symptom network in elderly stroke patients through network analysis,identify core symptoms,and analyze the influencing factors of these symptoms,providing a basis for developing precise symptom management strategies.Methods From January to May 2024,500 elderly stroke patients admitted to 4 tertiary A hospitals in Anhui province were selected using convenience sampling.Data were collected using a general information questionnaire,the stroke patients’ symptom experience scale (Stroke-SES),the multidimensional health locus of control scale (MHLC),and the brief illness perception questionnaire (BIPQ).A symptom network was constructed using R language,and centrality indices were analyzed.Univariate analysis,correlation analysis,and multiple linear regression were used to explore the influencing factors of multidimensional symptoms.Results The prevalence of multidimensional symptoms in elderly stroke patients ranged from 19.00% to 94.60%.Network analysis revealed that “decline in self-care ability” had the highest strength centrality and expected influence.Multiple linear regression analysis showed that physical activity level,internal health locus of control,chance health locus of control,and illness perception were significant influencing factors of symptom severity (all P＜0.01),explaining 63.24% of the total variance.Conclusions Decline in self-care ability is the core symptom within the multidimensional symptom network in elderly stroke patients and is influenced by multiple factors.Healthcare professionals can develop targeted intervention based on the core symptom and its related influencing factors to improve the effectiveness of symptom management.

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国家重点研发计划项目（2020YFC2008802）；安徽省人口健康基金会：助力人口高质量发展重大研究项目（RKJJ2024ZD02）；安徽医科大学护理学院研究生青苗培育项目（hlqm12024081）