肝癌患者靶向联合免疫治疗期间症状体验的质性研究

doi:10.3761/j.issn.0254-1769.2026.15.012

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (15): 2102-2108.DOI: 10.3761/j.issn.0254-1769.2026.15.012

肝癌患者靶向联合免疫治疗期间症状体验的质性研究

刘畅¹(), 陈达裕², 贺琰琳¹, 张爱梅³, 江明媚³, 任春霞¹^,^*()

¹ 安徽医科大学护理学院合肥市 230032
² 安徽医科大学第一附属医院高新院区心脏大血管外科ICU 合肥市 230088
³ 安徽医科大学第一附属医院肝胆胰外科合肥市 230000

收稿日期:2026-01-26 出版日期:2026-08-10 发布日期:2026-08-04
*通讯作者: 任春霞，E-mail：yfy201629@fy.ahmu.edu.cn
作者简介:刘畅：男，本科（硕士在读），E-mail：2345011292@stu.ahmu.edu.cn
第一联系人：作者贡献声明
刘畅：参与选题、访谈方案构建、访谈实施、论文撰写；陈达裕：访谈方案修改、研究指导；贺琰琳：参与选题、实施访谈；张爱梅、江明媚：实施访谈、研究指导；任春霞：确定选题、研究指导、方案构建及修改、访谈质量控制、论文修改、经费支持
基金资助:
2025年度安徽医科大学护理学院研究生青苗培育项目(Hlqm12025098)

A qualitative study on symptom experiences among hepatocellular carcinoma patients during targeted therapy combined with immunotherapy

LIU Chang¹(), CHEN Dayu², HE Yanlin¹, ZHANG Aimei³, JIANG Mingmei³, REN Chunxia¹^,^*()

¹ School of Nursing， Anhui Medical University， Hefei 230032， China
² Intensive Care Unit of Cardiovascular Surgery Department， Gaoxin District，the First Affiliated Hospital of Anhui Medical University， Hefei 230088， China
³ Depart-ment of Hepatobiliary and Pancreatic Surgery， the First Affiliated Hospital of Anhui Medical University， Hefei 230000， China

Received:2026-01-26 Online:2026-08-10 Published:2026-08-04
* Corresponding author: REN Chunxia，E-mail：yfy201629@fy.ahmu.edu.cn
Funding program:
2025 Anhui Medical University School of Nursing Graduate Student Talent Development Program(Hlqm12025098)

摘要/Abstract

摘要：

目的探讨肝癌患者靶向联合免疫治疗期间症状体验的真实感受，为临床护理策略提供参考。方法采用目的抽样方法，选取2025年5—6月在安徽省某三级甲等综合医院接受靶向联合免疫治疗的肝癌患者13例作为研究对象。依据不悦症状理论，对患者进行半结构化访谈，采用Colaizzi七步分析法分析资料，提炼主题。结果共凝练出3个主题和8个亚主题：躯体症状的多维表征与身心连锁效应（皮肤毒性所致社交疏离与身心困扰、消化系统症状引发的躯体功能减退与生活受限、疼痛侵袭下的负性心境与生存惶恐、严重不良反应引发的治疗信心动摇与安全感缺失）；治疗情境下的心理负担与角色适应挑战（疗效与副反应冲突带来的存在性焦虑、家庭角色倒置所致愧疚感与自我价值感缺失）；外部支持系统的结构特征与困境（经济压力感知与医疗成本应对、延续性护理的供需错位与患者体验落差）。结论接受靶向联合免疫治疗的肝癌患者症状负担受到生理、心理及环境因素的综合影响。医护人员应重视肝癌患者靶向联合免疫治疗期间的多维度症状体验，及时给予个体化照护，减轻患者不适症状，提升治疗效果与生活质量。

关键词: 靶向联合免疫治疗, 原发性肝癌, 症状体验, 质性研究, 不悦症状理论, 护理

Abstract:

Objective To explore the real-life experience of symptoms among hepatocellular carcinoma patients during targeted therapy combined with immunotherapy，thereby providing a reference for the development of appropriate nursing strategies and protocols in clinical practice. Methods Using purposive sampling，13 patients with hepatocellular carcinoma undergoing targeted therapy combined with immunotherapy at a tertiary A hospital in Anhui Province between May and June 2025 were selected as study subjects. Semi-structured interviews were conducted based on the theory of unpleasant symptoms. Data were analyzed using Colaizzi 7-step analysis method to extract themes. Results A total of 3 themes and 8 subthemes were identified：the multidimensional manifestations of physical symptoms and their psychosomatic chain reactions（social isolation and emotional disturbances caused by skin toxicity，physical disarray and contraction of daily life caused by gastrointestinal symptoms，negative mood and existential anxiety under the onslaught of pain，and the loss of confidence in treatment and a sense of insecurity caused by serious adverse reactions，psychological burden and challenges in role adaptation in therapeutic settings（existential anxiety arising from the trade-off between therapeutic efficacy and adverse reactions，feelings of guilt and loss of self-worth resulting from the reversal of family roles），and the structural characteristics and challenges of external support systems（perception of economic pressure and coping with medical costs，the mismatch between supply and demand for continuity of care and the gap in patient experience）. Conclusion During targeted therapy combined with immunotherapy period，the symptom burden of hepatocellular carcinoma patients was typically influenced by the combined effects of physiological，psychological，and environmental factors. Therefore，it is essential to implement timely and effective comprehensive interventions to alleviate patients’ discomfort and enhance overall treatment outcomes and quality of life.

Key words: Targeted Therapy Combined with Immunotherapy, Primary Hepatic Carcinoma, Symptom Experiences, Qualitative Research, Theory of Unpleasant Symptoms, Nursing Care

刘畅, 陈达裕, 贺琰琳, 张爱梅, 江明媚, 任春霞. 肝癌患者靶向联合免疫治疗期间症状体验的质性研究[J]. 中华护理杂志, 2026, 61(15): 2102-2108.

LIU Chang, CHEN Dayu, HE Yanlin, ZHANG Aimei, JIANG Mingmei, REN Chunxia. A qualitative study on symptom experiences among hepatocellular carcinoma patients during targeted therapy combined with immunotherapy[J]. Chinese Journal of Nursing, 2026, 61(15): 2102-2108.

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肝癌患者靶向联合免疫治疗期间症状体验的质性研究

A qualitative study on symptom experiences among hepatocellular carcinoma patients during targeted therapy combined with immunotherapy

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