化疗期肿瘤患者全链式随访系统的开发及可行性研究

doi:10.3761/j.issn.0254-1769.2025.02.008

摘要/Abstract

摘要：

目的构建化疗期肿瘤患者全链式随访系统，并评价其应用效果。方法基于患者实际需求，构建化疗期肿瘤患者全链式随访系统，包括健康档案、随访计划、风险识别与异常提醒、医护患在线咨询与交互、数据可视化分析及统计智能化管理5个模块。采用便利抽样法，选取2023年2月—6月在四川省德阳市某三级甲等医院就诊的96例化疗期肿瘤患者作为试验组，应用全链式随访系统进行随访;将2022年2月—6月就诊的93例化疗期肿瘤患者作为对照组，实施常规随访护理。系统应用前后对两组自我管理能力、生活质量及随访服务满意度指标进行比较。结果试验组94例、对照组92例完成研究。系统应用后，试验组癌症患者自我管理测评量表得分为（169.44±11.96）分，高于对照组的（150.76±13.44）分;癌症患者生命质量测定量表得分为（65.50±7.90）分，高于对照组的（59.81±7.27）分;随访服务满意度调查问卷得分为（52.00±3.30）分，高于对照组的（48.89±3.54）分，两组比较，差异均具有统计学意义（P<0.001）。结论全链式随访系统的应用满足了化疗期肿瘤患者多样化、多层次的随访需求，实现了精准化、专业化、智能化的护理随访服务，有效提升了患者的症状自我管理能力和生活质量，提高了对护理服务的满意度。

关键词: 化疗期, 人工智能, 全链式, 随访系统, 延续性护理, 肿瘤护理

Abstract:

Objective To establish a full-chain follow-up system for tumor patients during chemotherapy and to evaluate its application effect. Methods A full-chain follow-up system was built according to the actual needs of cancer patients during chemotherapy，including 5 modules：patient health records，follow-up plan，risk identification and abnormal reminder，online consultation，interaction between doctors and patients and data visualization analysis and intelligent statistical management. Convenience sampling method was used to select 96 patients with tumor at chemotherapy stage who were treated in a tertiary A hospital in Deyang City，Sichuan Province from February to June 2023 as a test group，and the full chain follow-up system for tumor patients at chemotherapy stage was applied for follow-up;93 patients with tumor at chemotherapy stage were treated from February to June 2022 as a control group for routine follow-up care. Indicators of self-management ability，quality of life and satisfaction with follow-up services were compared between the 2 groups before and after the application of the system. Results 94 cases in the test group and 92 cases in the control group completed the study. After the application of the system，the test group scored（169.44±11.96） on the Cancer Patients Self-Management Scale，higher than（150.76±13.44） in the control group. The score on the Cancer Patients Quality of Life Core Scale was（65.50±7.90），higher than（59.81±7.27） in the control group. The score on the Questionnaire of Satisfaction with the Follow-Up Service was（52.00±3.30），higher than（48.89±3.54） in the control group，and the difference between the 2 groups was statistically significant（P<0.001）. Conclusion The application of the full-chain follow-up system can meet the diversified and multi-level follow-up needs of tumor patients during chemotherapy，achieve accurate，professional and intelligent nursing follow-up services，effectively improve patients’ symptom self-management ability and quality of life，and improve patients’ satisfaction with nursing services.

Key words: Chemotherapy Period, Artificial Intelligence, Full Chain, Follow-Up System, Continuous Nursing, Oncologic Nursing

谭琳, 钟晓莉, 吴际军, 蒋福荣, 刘瑶, 何琳. 化疗期肿瘤患者全链式随访系统的开发及可行性研究[J]. 中华护理杂志, 2025, 60(2): 177-184.

TAN Lin, ZHONG Xiaoli, WU Jijun, JIANG Furong, LIU Yao, HE Lin. Construction and feasibility of a full chain follow-up system for tumor patients at chemotherapy stage[J]. Chinese Journal of Nursing, 2025, 60(2): 177-184.

图/表 4

表1 两组一般资料的比较[例（百分比，%）]

Table 1 Comparison of general data between 2 groups[cases（percentage，%）]

表2 系统应用前后两组自我管理能力的比较（分，$\bar{x} \pm s$）

Table 2 Comparison of self-management levels between 2 groups before and after application of artificial intelligence follow-up system（scores，$\bar{x} \pm s$）

表3 系统应用前后两组生活质量的比较（分，$\bar{x} \pm s$）

Table 3 Comparison of quality of life scores between 2 groups before and afterapplication of artificial intelligence follow-up system（scores，$\bar{x} \pm s$）

表4 系统应用前后两组随访服务满意度的比较（分，$\bar{x} \pm s$）

Table 4 Comparison of quality of life scores between 2 groups before and afterapplication of artificial intelligence follow-up system（scores，$\bar{x} \pm s$）

参考文献 20

[1]	Zheng R, Chen R, Han B, et al. Cancer incidence and mortality in China,2022[J]. J Natl Cancer Cent, 2024, 46(3):221-231.
[2]	Cao MM, Li H, Sun DQ, et al. Current cancer burden in China:epidemiology,etiology,and prevention[J]. Cancer Biol Med, 2022, 19(8):1121-1138.
[3]	王培宇, 黄祺, 王少东, 等. 《全球癌症统计数据2022》要点解读[J]. 中国胸心血管外科临床杂志, 2024, 31(7):933-954.
	Wang PY, Huang Q, Wang SD, et al. Interpretation of the key points of “global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries”[J]. Chin J Clin Thorac Cardiovasc Surg, 2024, 31(7):933-954.
[4]	Wang AB, Housley SN, Flores AM, et al. A review of movement disorders in chemotherapy-induced neurotoxicity[J]. J Neuroeng Rehabil, 2021, 18(1):16. DOI PMID
[5]	郭苗苗, 严婷婷, 许丹丹, 等. 乳腺癌患者全病程管理信息系统的开发与应用研究[J]. 中华护理杂志, 2024, 59(8):901-908. DOI URL
	Guo MM, Yan TT, Xu DD, et al. Development and application of a whole course management information system for breast cancer[J]. Chin J Nurs, 2024, 59(8):901-908. DOI URL
[6]	赵雯雯, 李鹏, 卢菲, 等. 多发性骨髓瘤患者人工智能随访系统的构建及应用[J]. 中华护理杂志, 2023, 58(15):1826-1830. DOI URL
	Zhao WW, Li P, Lu F, et al. Construction and application of artificial intelligence follow-up system for multiple myeloma patients[J]. Chin J Nurs, 2023, 58(15):1826-1830. DOI URL
[7]	王婷, 张静, 于淼. 肺癌化疗患者未满足需求发展轨迹的调查研究[J]. 中华护理杂志, 2022, 57(17):2068-2072. DOI URL
	Wang T, Zhang J, Yu M. An investigation of developmental trajectory of unmet needs in lung cancer patients undergoing chemotherapy[J]. Chin J Nurs, 2022, 57(17):2068-2072.
[8]	国家卫生健康委. 关于印发进一步改善护理服务行动计划(2023—2025年)的通知[EB/OL]. (2023-06-15)[2024-03-20]. https://www.gov.cn/zhengce/zhengceku/202306/content_6887303.htm?dzb=true.
	National Health Commission. Notice on issuing the action plan for further improving nursing services(2021—2025)[EB/OL]. (2023-06-15)[2024-03-20]. https://www.gov.cn/zhengce/zhengceku/202306/content_6887303.htm?dzb=true.
[9]	You MM, Tian M, Song ZL, et al. Selection of GalNAc-conjugated siKeap1 as disease-specific delivery system for chemotherapy-induced liver injury and chronic liver disease[J]. Nano Lett, 2024, 24(4):1096-1105.
[10]	程玲灵, 孙玉倩. 癌症患者自我管理测评量表的编制及信效度检验[J]. 中华护理杂志, 2017, 52(9):1082-1087.
	Cheng LL, Sun YQ. Development and validation of Cancer Patient Self-management Assessment Scale[J]. Chin J Nurs, 2017, 52(9):1082-1087.
[11]	Aaronson NK, Ahmedzai S, Bergman B, et al. EORTC QLQ-30:a quality of life instrument for use in international clinical trials in oncology[J]. J Natl Cancer Inst, 1993, 85,365-376. DOI PMID
[12]	万崇华, 陈明清, 张灿珍, 等. 癌症患者生命质量测定量表EORTC QLQ-C30中文版评介[J]. 实用肿瘤杂志, 2005, 20(4):353-355.
	Wan CH, Chen MQ, Zhang CZ, et al. The Chinese version of EORTC QLQ-C30 form in evaluation of quality of life for patients with cancer[J]. J Pract Oncol, 2005, 20(4):353-355.
[13]	朱慧, 沈利凤, 吕恬, 等. 多模态体感运动对甲状腺癌全切术后患者的干预效果研究[J]. 中华护理杂志, 2023, 58(14):1691-1699. DOI URL
	Zhu H, Shen LF, Lü T, et al. Effect of multimodal somatosensory exercise in patients after total thyroidectomy[J]. Chin J Nurs, 2023, 58(14):1691-1699. DOI URL
[14]	戴琪, 李方, 张筱童, 等. 肺癌患者全链式随访系统的设计与应用[J]. 护理学杂志, 2022, 37(12):47-50.
	Dai Q, Li F, Zhang XT, et al. Design and application of “full-chain” nursing follow-up system for perioperative patients with lung cancer[J]. J Nurs Sci, 2022, 37(12):47-50.
[15]	吴国凤, 李芯睿, 钟美容, 等. 基于云平台的延续护理对乳腺癌患者阈下抑郁影响的研究[J]. 中华护理杂志, 2024, 59(2):142-148. DOI URL
	Wu GF, Li XR, Zhong MR, et al. The effect of a mobile health intervention model based on self-determination theory on subthreshold depression in breast cancer patients[J]. Chin J Nurs, 2024, 59(2):142-148. DOI URL
[16]	田雨同, 张艳, 侯小花, 等. “互联网+护理服务”平台的构建及应用研究[J]. 中华护理杂志, 2020, 55(10):1537-1542. DOI URL
	Tian YT, Zhang Y, Hou XH, et al. Research on the construction and application of internet nursing service platform[J]. Chin J Nurs, 2020, 55(10):1537-1542.
[17]	廖婷婷, 杨丽, 王仁生, 等. 鼻咽癌患者家庭延续性护理平台的构建与应用研究[J]. 中华护理杂志, 2020, 55(9):1399-1405. DOI URL
	Liao TT, Yang L, Wang RS, et al. Construction and application of home-based continuous care platform for patients with nasopharyngeal carcinoma[J]. Chin J Nurs, 2020, 55(9):1399-1405. DOI URL
[18]	易国仲, 徐海艳, 李志勇, 等. 胶质瘤患者全程管理随访系统构建及其价值研究[J]. 中国医学装备, 2023, 20(1):110-113.
	Yi GZ, Xu HY, Li ZY, et al. Research on the construction and value of whole-process management and follow-up system for glioma[J]. China Med Equip, 2023, 20(1):110-113.
[19]	蒋清群, 周萍, 郑琰, 等. 基于云随访平台的医院-家庭连续性护理在老年前列腺癌根治术患者中的应用[J]. 中华护理杂志, 2022, 57(11):1297-1303. DOI URL
	Jiang QQ, Zhou P, Zheng Y, et al. The effects of hospital-home continuum nursing based on a cloud follow-up platform in elderly patients with radical prostatectomy[J]. Chin J Nurs, 2022, 57(11):1297-1303. DOI URL
[20]	覃梦霞, 潜艳, 徐蓉, 等. 基于互联网+肺康复全程健康教育在肺癌手术患者中的应用[J]. 中华护理杂志, 2023, 58(15):1808-1814. DOI URL
	Qin MX, Qian Y, Xu R, et al. The application of Internet based whole health education of pulmonary rehabilitation in patients undergoing lung cancer surgery[J]. Chin J Nurs, 2023, 58(15):1808-1814. DOI URL