ObjectiveTo investigate the incidence, severity and longitudinal trajectories of symptoms at various time points in the perioperative period of lung cancer patients, and to provide scientific basis for clinical staff to implement predictive nursing and dynamic management of symptom clusters. MethodsA prospective longitudinal investigation was conducted. The patients with lung cancer who underwent thoracoscopic lung surgery in four wards of the Department of Thoracic Surgery in our hospital were investigated by face-to-face and telephone follow-up before surgery, 1-2 days after surgery, on the day of discharge and 2 weeks after discharge. The investigation tool was the revised Chinese version of MD Anderson Symptom Inventory lung cancer specific module. Results A total of 192 patients with lung cancer were included in this study, including 59 males and 133 females, with an average age of 55.68±11.01 years. There were two symptom clusters (respiratory-gastrointestinal and emotional/psychological-disturbed sleep symptom clusters) before surgery, three symptom clusters (respiratory, gastrointestinal, and emotional/psychological-disturbed sleep symptom clusters) 1-2 days after surgery, three symptom clusters (pain-fatigue-emotional/psychological, respiratory, and gastrointestinal symptom clusters) on the day of discharge, and two symptom clusters (pain-fatigue-respiratory and respiratory symptom clusters) 2 weeks after discharge. The composition of symptoms was different in each time point during perioperative period. ConclusionThere are four symptom clusters in patients with lung cancer during perioperative period, which are pain-fatigue-disturbed sleep symptoms, gastrointestinal symptoms, respiratory symptoms and emotional/psychological symptoms. The symptom clusters of lung cancer patients at different time points are relatively stable, but the symptoms within the symptom clusters show dynamic changes. Medical staff should attach great importance to and continuously monitor the dynamic changes of perioperative symptom groups of lung cancer patients, do relevant education and nursing in advance, and timely adjust the management plan according to the symptom group evaluation results.
ObjectiveTo explore the independent risk factors for postoperative retention of urinary catheters in the ward of lung tumor patients due to urinary retention under the concept of enhanced recovery after surgery (ERAS).MethodsSeventy-five patients with lung tumors who had urinary catheters left in the postoperative ward between June 2019 and August 2019 were selected as a case group, and 75 patients with lung tumors who did not have urinary catheters in the perioperative period as a control group. Independent risk factors for indwelling urinary catheters in the postoperative ward were screened by univariate and multiple-variate logistic stepwise regression analysis.ResultsThere were 45 males and 30 females in the case group with an average age of 55.33±10.78 years, 28 males and 47 females in the control group with an average age of 57.12±10.06 years. Univariate analysis showed that gender, operative time>2 h, intraoperative fluid volume≥1 200 mL, and fluid volume within 6 h of returning to the ward after surgery>1 200 mL were associated with the occurrence of indwelling urinary catheters in patients with lung tumors in postoperative wards (P<0.05). Multiple-variate logistic regression showed that male (OR=2.311, 95%CI 1.173-4.552, P=0.015), infusion volume within 6 h of returning to the ward after surgery>1 200 mL (OR=2.491, 95%CI 1.149-5.401, P=0.021) and intraoperative infusion volume≥1 200 mL (OR=2.105, 95%CI 1.022-4.340, P=0.044) were independent risk factors for postoperative retention of urinary catheters in patients with lung tumors.ConclusionThe occurrence of indwelling urinary catheter in lung tumor patients under the ERAS concept is the result of a combination of factors, and patients who are male, have infusion volume>1 200 mL within 6 h of returning to the ward after surgery, and have intraoperative infusion volume≥1 200mL are the high-risk group for postoperative ward indwelling urinary catheter, and health care personnel should strengthen the assessment and observation, provide targeted health education, appropriately control the perioperative fluid volume, and take other measures to reduce the occurrence of indwelling urinary catheters due to urinary retention postoperatively in ward.