目的 了解恶性肿瘤伤口患者确诊后不同时间的伤口症状对其生活困扰水平的变化轨迹,并探究其影响因素。方法 采用纵向研究设计,分别在106例患者病理确诊时（T1）、诊断后1个月（T2）、诊断后3个月（T3）、诊断后6个月（T4）评估其伤口症状生活困扰水平,比较不同治疗阶段伤口症状生活困扰水平差异并分析其影响因素。结果 伤口症状生活困扰得分T1（49.20±13.78）分、T2（57.71±13.47）分、T3（45.58±13.69）分、T4（43.79±12.98）分。治疗阶段、性别、伤口渗液、伤口气味、伤口瘙痒和换药频率是伤口症状生活困扰的影响因素。结论 恶性肿瘤伤口患者伤口症状生活困扰水平呈现先升高后降低的变化趋势,应加强恶性肿瘤伤口患者的早期评估、持续追踪和全程症状管理,降低其伤口症状生活困扰水平。

Objective To understand the change trajectory and influencing factors of wound symptom distress at different times after the diagnosis of malignant tumor wound. Methods A longitudinal study design was used to evaluate patients’ wound symptom distress at the time of pathological diagnosis （T1）,1 month after diagnosis （T2）,3 months after diagnosis（T3）,and 6 months after diagnosis （T4）. The distress in different periods was compared and the influencing factors of symptom distress were analyzed. Results The wound Symptom Intrusiveness score：T1 （49.20±13.78）,T2 （57.71±13.47）,T3 （45.58±13.69）,and T4 （43.79±12.98）. Treatment stage,gender,wound exudation,wound odor,wound pruritus and dressing change frequency were the influencing factors of wound symptoms distress. Conclusion The trajectory of wound symptom distress in patients with malignant fungating wounds firstly going high then becoming low. Early evaluation,continuous follow-up and whole process symptom management of patients with malignant fungating wounds should be strengthened to reduce wound symptoms and improve the quality of life of patients.