引用文本：张元佳, 寇萌佳, 杨锴鹏, 等. 胃肠肿瘤患者发生术后睡眠障碍的影响因素分析[J/CD]. 消化肿瘤杂志（电子版）, 2025, 17(2):204-212.

作者：张元佳¹，寇萌佳²，杨锴鹏¹，赵旭¹，徐唯一¹，吴施惠¹，黄婵燕¹，张妙音¹

单位：1.中山大学附属第一医院 麻醉科，广东 广州 510080；2.北京大学第一医院 麻醉科，北京 100034

Authors：Zhang Yuanjia¹, Kou Mengjia², Yang Kaipeng¹, Zhao Xu¹, Xu Weiyi¹, Wu Shihui¹, Huang Chanyan¹, Zhang Miaoyin¹

Unit：1. Department of Anesthesiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, Guangdong, China；2. Department of Anesthesiology, Peking University First Hospital, Beijing 100034, China

摘要：

目的 探讨拟择期行胃肠肿瘤切除术患者术后睡眠障碍（postoperative sleep disturbance, PSD）的发生率及其相关影响因素。 方法 本研究为单中心、前瞻性、观察性队列研究，共纳入2023年3月至2024年3月在中山大学附属第一医院拟择期行胃肠肿瘤切除术的成年患者283例，使用理查兹-坎贝尔睡眠量表（Richards-Campbell sleep questionnaire, RCSQ）评估术前夜和术后第1、2、3夜的睡眠质量。主要终点指标为术后RCSQ评分评估的PSD发生率（术后连续3夜的RCSQ平均分数被定义为术后RCSQ评分，评分≤50分的患者视为存在PSD）。根据术后RCSQ评分，将患者分为PSD组（n=110）和非PSD组（n=173）。比较两组患者术前、术中和术后资料的差异，并通过单因素和多因素Logistic回归分析，确定PSD的独立影响因素。 结果 本研究纳入患者的总体PSD发生率为38.87%（110/283），所有患者的术后RCSQ评分为（54.55±16.42）分。术后第1夜PSD发生率高于第2、3夜（51.59%比35.34%比30.74%）。多因素Logistic回归分析显示，术前夜RCSQ评分较高、有吸烟史和手术部位（结肠、直肠）是PSD的独立保护因素（P＜0.05），麻醉开始时间（15:00—22:00）、术后疼痛数字分级评分法评分较高和对病房环境不满意是PSD的独立危险因素（P＜0.05）。 结论 胃肠肿瘤患者PSD较普遍，应引起医护人员高度重视。识别与PSD相关的影响因素有利于围手术期的睡眠障碍风险评估和改善睡眠质量干预措施的制定。

关键词：术后睡眠障碍；胃肠肿瘤；危险因素；理查兹-坎贝尔睡眠量表

Abstract：

Objective This study aimed to determine the prevalence of postoperative sleep disturbance (PSD) and to explore associated influencing factors in patients scheduled for elective gastrointestinal tumor resection surgery. Method This was a single-center prospective observational study. A total of 283 adult patients scheduled for elective gastrointestinal tumor resection surgery at the First Affiliated Hospital of Sun Yat-sen University from March 2023 to March 2024 were included. Patients were followed up the day before surgery and for the three consecutive postoperative days. The Richards-Campbell sleep questionnaire (RCSQ) was utilized to assess sleep quality on the night before surgery and the first, second, and third nights after surgery. The primary end point was the incidence of PSD assessed by the postoperative RCSQ score (the average RCSQ score over three consecutive nights after surgery was defined as the postoperative RCSQ score, with patients scoring ≤50 points considered to have PSD). Based on the postoperative RCSQ score, patients were divided into the PSD group (n=110) and the non-PSD group (n=173). The differences in preoperative, intraoperative, and postoperative data between the two groups of patients were compared, and the independent influencing factors of PSD were determined through univariate and multivariate Logistic regression analysis. Result The overall incidence of PSD was found to be 38.87% (110/283), with a postoperative RCSQ score of (54.55±16.42) points for all patients. The incidence of PSD on the first postoperative night was higher than that on the second and third postoperative nights (51.59% vs. 35.34% vs. 30.74%). Multivariate Logistic regression analysis indicated that, higher RCSQ score on the night before surgery, smoking history and the surgical site (colon, rectum) were independent protective factors for PSD (P<0.05), while anesthesia time (15:00-22:00), higher score of numerical rating scale for postoperative pain, and patient dissatisfaction with the ward environment were independent risk factors for PSD (P<0.05). Conclusion Patients undergoing gastrointestinal tumor resection commonly experience significant PSD, which warrant increased clinical attention. Identifying influencing factors associated with PSD will facilitate perioperative risk stratification of PSD and the development of targeted interventions to improve sleep quality.

Key words：Postoperative sleep disturbance; Gastrointestinal tumor; Risk factors; Richards-Campbell sleep questionnaire

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