高血压脑出血微创术后患者核心症状的纵向研究

doi:10.3761/j.issn.0254-1769.2026.18.008

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (18): 2510-2518.DOI: 10.3761/j.issn.0254-1769.2026.18.008

高血压脑出血微创术后患者核心症状的纵向研究

王鑫¹(), 王贝贝², 薛婷³, 宋守昊⁴, 汤继文⁵, 李长春¹, 姜永梅⁶^,^*()

¹ 青岛大学护理学院青岛市 266021
² 青岛大学附属医院口腔颌面外科、乳腺甲状腺外科青岛市 266000
³ 青岛大学附属医院新生儿科青岛市 266000
⁴ 山东第一医科大学护理学院泰安市 271016
⁵ 青岛大学附属医院重症医学科青岛市 266000
⁶ 青岛大学附属医院护理院感处青岛市 266000

收稿日期:2026-05-09 出版日期:2026-09-20 发布日期:2026-09-23
*通讯作者: *姜永梅，E-mail：jymqyfy@163.com
作者简介:王鑫：女，本科（硕士在读），护士，E-mail：17866713951@163.com
第一联系人：作者贡献声明
王鑫：研究设计、统计学分析、论文撰写；王贝贝：研究指导、论文修改；薛婷：统计学分析、论文修改；宋守昊：数据收集与整理；汤继文、李长春：数据收集；姜永梅：研究指导、基金支持、论文审阅与修改
基金资助:
青岛市医疗卫生科研项目(2025-WJKY182)

A longitudinal study of core symptoms in patients with hypertensive cerebral hemorrhage after minimally invasive surgery

WANG Xin¹(), WANG Beibei², XUE Ting³, SONG Shouhao⁴, TANG Jiwen⁵, LI Changchun¹, JIANG Yongmei⁶^,^*()

¹ School of Nursing， University of Qingdao， Qingdao 266021， China
² Oral and Maxillofacial Surgery， Breast and Thyroid Surgery，the Affiliated Hospital of Qingdao University， Qingdao 266000， China
³ Department of Neonatology， the Affiliated Hospital of Qingdao University， Qingdao 266000， China
⁴ School of Nursing， Shandong First Medical University， Taian 271016， China
⁵ Department of Intensive Care Medicine， the Affiliated Hospital of Qingdao University， Qingdao 266000， China
⁶ Nursing Department of Infection Control， the Affiliated Hospital of Qingdao University， Qingdao 266000， China

Received:2026-05-09 Online:2026-09-20 Published:2026-09-23
* Corresponding author: *JIANG Yongmei，E-mail：jymqyfy@163.com
Funding program:
Qingdao Medical and Health Scientific Research Project(2025-WJKY182)

摘要/Abstract

摘要：

目的基于网络分析，探讨高血压脑出血微创术后患者不同时期症状群及核心症状的变化。方法采用便利抽样法，选取2025年4月—2026年1月在青岛市某三级甲等医院神经外科行微创手术治疗的294例高血压脑出血患者作为调查对象，使用脑卒中症状体验量表分别于术后1周（T1）、术后1个月（T2）、术后3个月（T3）进行症状评估。使用探索性因子分析法提取症状群并运用R软件构建症状网络。结果共261例患者完成全程调查，有效问卷回收率为88.78%。各时期均提取3个症状群。在症状网络中，T1自理能力下降是强度（r_s=1.524）、紧密中心性（r_c=0.005）和中介中心性（r_b=108）最大的症状；T2闷闷不乐是强度（r_s=1.352）最大的症状，容易着急是紧密中心性（r_c=0.004）和中介中心性（r_b=124）最大的症状；T3因不能做想做的事情烦恼是强度（r_s=1.363）和中介中心性（r_b=120）最大的症状，自理能力下降是紧密中心性（r_c=0.004）最大的症状。结论高血压脑出血微创术后患者症状群持续稳定存在；T1以自理能力下降为核心症状，T2以闷闷不乐为核心症状、容易着急为桥梁症状，T3为功能-心理双核心。临床应实施分阶段靶向干预，提升术后康复管理效率。

关键词: 颅内出血, 高血压性, 核心症状, 症状群, 网络分析, 纵向研究, 护理

Abstract:

Objective To explore changes in symptom clusters and identify core symptoms at different stages in patients after minimally invasive surgery for hypertensive intracerebral hemorrhage using network analysis. Methods A total of 294 patients who underwent minimally invasive surgery for hypertensive intracerebral hemorrhage in the neurosurgery department of a tertiary hospital in Qingdao from April 2025 to January 2026 were recruited by convenience sampling. Symptom assessments were conducted using the Stroke Symptom Experience Scale at 1 week （T1），1 month（T2），and 3 months（T3） postoperatively. Exploratory factor analysis was used to extract symptom clusters，and symptom networks were constructed using R software. Results All 261 patients completed the entire follow-up，with an effective response rate of 88.78%. A total of 3 symptom clusters were consistently extracted at each time point. In the symptom network，decreased self-care ability exhibited the highest strength（r_s=1.524），closeness centrality（r_c=0.005），and betweenness centrality（r_b=108） at T1. At T2，depressed mood had the highest strength（r_s=1.352），while being easily anxious showed the highest closeness centrality（r_c=0.004） and betweenness centrality（r_b=124）. At T3，distress due to inability to engage in desired activities had the highest strength（r_s=1.363） and betweenness centrality（r_b=120），and decreased self-care ability had the highest closeness centrality（r_c=0.004）. Conclusions Symptom clusters remained stable over time but core symptoms transitioned across stages. Decreased self-care ability was the core symptom at T1；depressed mood was the core symptom and being easily anxious was the bridge symptom at T2；psychological distress combined with decreased self-care ability formed a dual-core structure at T3. Staged and targeted interventions should be implemented to improve postoperative rehabilitation management efficiency.

Key words: Intracranial Hemorrhage, Hypertensive, Core Symptoms, Symptom Clusters, Network Analysis, Longitudinal Studies, Nursing Care

王鑫, 王贝贝, 薛婷, 宋守昊, 汤继文, 李长春, 姜永梅. 高血压脑出血微创术后患者核心症状的纵向研究[J]. 中华护理杂志, 2026, 61(18): 2510-2518.

WANG Xin, WANG Beibei, XUE Ting, SONG Shouhao, TANG Jiwen, LI Changchun, JIANG Yongmei. A longitudinal study of core symptoms in patients with hypertensive cerebral hemorrhage after minimally invasive surgery[J]. Chinese Journal of Nursing, 2026, 61(18): 2510-2518.

图/表 6

表1 高血压脑出血微创术后患者的一般资料（n=261）

Table 1 General demographic data of patients undergoing minimally invasive surgery for hypertensive intracerebral hemorrhage（n=261）

表2 高血压脑出血微创术后患者症状发生率及严重程度（n=261）

Table 2 Incidence and severity of symptoms in patients after minimally invasive surgery for hypertensive cerebral hemorrhage（n=261）

表3 高血压脑出血微创术后患者不同时期症状群的提取结果（n=261）

Table 3 Extraction results of symptom clusters in patients after minimally invasive surgery for hypertensive intracerebral hemorrhage at different time points（n=261）

图1 高血压脑出血微创术后患者T1时期症状网络注：S1肢体活动受限，S2肢体无力，S3肢体疼痛，S4肩痛，S5上肢屈曲，S6足下垂，S7足内翻，S8四肢动作不协调，S9无法保持身体平衡，S10肢体感觉减退，S11记忆力下降，S12注意力下降，S13反应变慢，S14说话不清，S16容易着急，S17闷闷不乐，S18对前途失望，S19对周围活动没兴趣，S20因不能做想做的事情烦恼，S21缺乏主动积极性，S22疲乏，S23自理能力下降。

Figure 1 Symptom network diagram of patients with hypertensive intracerebral hemorrhage after minimally invasive surgery at T1

图2 高血压脑出血微创术后患者T2时期症状网络注：S1肢体活动受限，S2肢体无力，S3肢体疼痛，S4肩痛，S5上肢屈曲，S6足下垂，S7足内翻，S8四肢动作不协调，S9无法保持身体平衡，S10肢体感觉减退，S11记忆力下降，S12注意力下降，S13反应变慢，S14说话不清，S15进食呛咳，S16容易着急，S17闷闷不乐，S18对前途失望，S19对周围活动没兴趣，S20因不能做想做的事情烦恼，S21缺乏主动积极性，S22疲乏，S23自理能力下降。

Figure 2 Symptom network diagram of patients with hypertensive intracerebral hemorrhage after minimally invasive surgery at T2

图3 高血压脑出血微创术后患者T3时期症状网络注：S1肢体活动受限，S2肢体无力，S5上肢屈曲，S8四肢动作不协调，S9无法保持身体平衡，S10肢体感觉减退，S11记忆力下降，S12注意力下降，S13反应变慢，S14说话不清，S15进食呛咳，S16容易着急，S17闷闷不乐，S18对前途失望，S19对周围活动没兴趣，S20因不能做想做的事情烦恼，S21缺乏主动积极性，S22疲乏，S23自理能力下降。

Figure 3 Symptom network diagram of patients with hypertensive intracerebral hemorrhage after minimally invasive surgery at T3

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高血压脑出血微创术后患者核心症状的纵向研究

A longitudinal study of core symptoms in patients with hypertensive cerebral hemorrhage after minimally invasive surgery

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