目的 对维持性血液透析患者症状群相关研究进行范围综述。方法 系统检索PubMed、 Embase、Web of Science、CINAHL、Medline、SinoMed、知网、万方和维普，检索时限为建库至2024年9月26日，并筛选文献、提取数据和绘制图表。 结果 共纳入16篇文献，提取31个症状群，常见症状群包括消化道症状群、情感症状群、水电解质症状群等；涉及8个评估工具，均为多症状评估量表；主要运用探索性因子分析和主成分分析提取症状群，症状群影响因素包括性别、年龄、透析龄、尿量、血红蛋白等。 结论 维持性血液透析患者症状群类型多样，未来有必要开发适合我国国情的MHD患者症状评估工具，探讨症状群最佳命名方式，加强症状群作用机制研究，探寻适合核心、桥梁和前哨症状的识别方法，继续探索症状群的影响因素，以便医护人员构建针对性的症状干预方案。
Objective To conduct a scoping review of the studies relating to symptom clusters in maintenance hemodialysis (MHD) patients, so as to provide references for symptom management by healthcare professionals. Methods This study strictly followed the scoping review method reported by Arksey and O'Malley. We systematically searched PubMed, Embase, WOS, CINAHL, Medline, SinoMed, CKNI, WanFang and VIP, with a timeframe from the establishment of the database to September 26, 2024. The searched references were screened, and the useful data and graphics were extracted. Results A total of 16 articles were included, and 31 symptom clusters were extracted. The common types of symptom clusters included gastrointestinal symptom clusters, affective symptom clusters, water and electrolyte symptom clusters, and others. Eight assessment tools were involved, all of which were multi-symptom assessment scales. Symptom clusters were extracted mainly by using exploratory factor analysis and principal component analysis. The influencing factors of the symptom clusters included gender, age, dialysis age, urine output, hemoglobin, and others. Conclusion Various types of symptom clusters are present in MHD patients. It is necessary to explore a symptom assessment tool suitable for the MHD patients in China, the optimal nomenclature of symptom clusters, the mechanism underlying the symptom clusters, the methods appropriate for the identification of core, bridge and sentinel symptoms, and the factors influencing symptom clusters, in order for healthcare professionals to establish a targeted symptom intervention program.
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