创伤骨科患者症状群研究的范围综述

Symptom Cluster Study of Orthopaedic Trauma Patients: A Scoping Review

摘要: 目的：对创伤骨科患者症状群研究文献进行范围综述，为完善骨科创伤患者症状群管理提供参考。方法：检索9个国内外数据库收录的创伤骨科患者症状群相关研究，检索时间为建库至2024年3月1日。结果：共纳入9篇文献，提取7个症状群，包括疼痛、心理、应激障碍、神经肌肉、疲乏、药物依赖、认知相关症状群，症状群评估工具均为多症状评估量表，症状群的影响因素主要包括社会人口学因素、疾病与治疗因素、躯体与心理因素等。结论：创伤骨科症状群研究尚处于发展阶段。未来研究应重点关注：1) 在深入理解生物学机制基础上，规范症状群的命名与界定；2) 应用统计学分类方法(如潜类别分析)精准识别症状群，并纵向追踪其动态演变轨迹；3) 深化症状协同效应的机制探索，加强生物标志物与症状网络的研究，为精准干预提供靶点。

Abstract: Objective: To conduct a scoping review of the literature on symptom clusters in patients with orthopedic trauma, aiming to provide references for improving the management of symptom clusters in these patients. Methods: A systematic search was performed across nine domestic and international databases for studies related to symptom clusters in patients with orthopedic trauma, covering the period from database inception to March 1, 2024. Results: A total of nine studies were included, identifying seven symptom clusters, including pain, psychological, stress disorder, neuromuscular, fatigue, medication dependence, and cognition-related clusters. The assessment tools for symptom clusters were all multi-symptom evaluation scales. The influencing factors of symptom clusters mainly included sociodemographic factors, disease- and treatment-related factors, as well as physical and psychological factors. Conclusion: Research on symptom clusters in orthopedic trauma is still in a developmental stage. Future studies should focus on: 1) standardizing the nomenclature and definition of symptom clusters based on a deeper understanding of biological mechanisms; 2) applying statistical classification methods (e.g., latent class analysis) for accurate identification of symptom clusters and longitudinally tracking their dynamic trajectories; 3) deepening the exploration of the mechanisms underlying symptom synergy, and strengthening research on biomarkers and symptom networks to provide targets for precise intervention.