肝癌术后患者的纵向症状动态：交叉滞后面板网络分析
Longitudinal symptom dynamics in postoperative patients with liver cancer: A cross-lagged panel network analysis.
摘要(中文译文)
本研究旨在采用交叉滞后面板网络（CLPN）模型探讨肝癌患者术后症状间的动态时间关联，并识别各阶段的核心症状，为针对性临床干预提供依据。本研究为纵向研究，纳入230例肝癌患者。采用安德森症状评估量表（MDASI）和原发性肝癌特异性症状模块（SM-PLC）于术后5个时间点进行评估：术后2天（T1）、1周（T2）、3周（T3）、1个月（T4）和3个月（T5）。应用CLPN模型估计症状间的交叉滞后关联，计算预期流出影响（out-EI）和预期流入影响（in-EI）以识别动态网络中的核心症状。从T1至T2，黄疸的out-EI最高，并显著预测呕吐（OR = 1.94，95% CI [1.70, 2.14]）。瘙痒预测麻木（OR = 1.41，95% CI [1.31, 1.52]），疼痛预测悲伤（OR = 1.35，95% CI [1.05, 1.47]）。从T2至T3，呕吐的out-EI最高，并预测黄疸（OR = 2.64，95% CI [2.17, 2.84]），而麻木与瘙痒之间呈双向关联（OR = 2.64，95% CI [2.17, 2.74]；OR = 1.21，95% CI [1.00, 1.71]）。从T3至T4，呕吐预测腹胀（OR = 1.57，95% CI [1.00, 1.64]）和食欲减退（OR = 1.41，95% CI [1.07, 1.62]），发热预测食欲减退（OR = 1.28，95% CI [1.14, 1.42]）。从T4至T5，悲伤的out-EI最高，并预测睡眠紊乱（OR = 1.35，95% CI [1.22, 1.47]）、食欲减退（OR = 1.21，95% CI [1.15, 1.46]）和疲乏（OR = 1.26，95% CI [1.15, 1.51]）。肝癌患者术后症状动态呈现明显的阶段特异性模式。黄疸和呕吐在术后早期占主导地位，而悲伤在后期成为核心症状。这些发现可为时间敏感且针对症状的护理干预提供依据，以改善术后症状管理。
Abstract
This study aimed to investigate the dynamic temporal associations among postoperative symptoms in patients with liver cancer using a cross-lagged panel network (CLPN) model, and to identify stage-specific core symptoms to inform targeted clinical interventions. A longitudinal study was conducted involving 230 patients with liver cancer. Symptoms were assessed using the MD Anderson Symptom Inventory (MDASI) and the Symptom Module Specific to Primary Liver Cancer (SM-PLC) at five time points: 2 days (T1), 1 week (T2), 3 weeks (T3), 1 month (T4), and 3 months (T5) postoperatively. A CLPN model was applied to estimate cross-lagged associations among symptoms. Out-expected influence (out-EI) and in-expected influence (in-EI) were calculated to identify central symptoms within the dynamic network. From T1 to T2, jaundice exhibited the highest out-EI and significantly predicted vomiting (OR = 1.94, 95% CI [1.70, 2.14]). Pruritus predicted numbness (OR = 1.41, 95% CI [1.31, 1.52]), and pain predicted sadness (OR = 1.35, 95% CI [1.05, 1.47]). From T2 to T3, vomiting showed the highest out-EI and predicted jaundice (OR = 2.64, 95% CI [2.17, 2.84]), while bidirectional associations were observed between numbness and pruritus (OR = 2.64, 95% CI [2.17, 2.74]; OR = 1.21, 95% CI [1.00, 1.71]). From T3 to T4, vomiting predicted bloating (OR = 1.57, 95% CI [1.00, 1.64]) and loss of appetite (OR = 1.41, 95% CI [1.07, 1.62]), while fever predicted loss of appetite (OR = 1.28, 95% CI [1.14, 1.42]). From T4 to T5, sadness exhibited the highest out-EI and predicted disturbed sleep (OR = 1.35, 95% CI [1.22, 1.47]), loss of appetite (OR = 1.21, 95% CI [1.15, 1.46]), and fatigue (OR = 1.26, 95% CI [1.15, 1.51]). Postoperative symptom dynamics in patients with liver cancer demonstrate clear stage-specific patterns. Jaundice and vomiting dominate early postoperative phases, whereas sadness becomes the central symptom in later stages. These findings may inform time-sensitive and symptom-targeted nursing interventions to improve postoperative symptom management.
如何引用
AMA
Suting Zhang, Yanxiu Cai, Mi Zhao, Ting Luo, Ying Zhu, Jing Han. Longitudinal symptom dynamics in postoperative patients with liver cancer: A cross-lagged panel network analysis.. Asia-Pacific journal of oncology nursing. 2026; doi:10.1016/j.apjon.2026.100960.
APA
Suting Zhang, Yanxiu Cai, Mi Zhao, Ting Luo, Ying Zhu, Jing Han (2026). Longitudinal symptom dynamics in postoperative patients with liver cancer: A cross-lagged panel network analysis.. Asia-Pacific journal of oncology nursing. https://doi.org/10.1016/j.apjon.2026.100960
GB/T 7714
Suting Zhang, Yanxiu Cai, Mi Zhao, Ting Luo, Ying Zhu, Jing Han. Longitudinal symptom dynamics in postoperative patients with liver cancer: A cross-lagged panel network analysis.[J]. Asia-Pacific journal of oncology nursing, 2026 doi:10.1016/j.apjon.2026.100960.
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