周術期消化器がん患者の倦怠感の変化と運動機能，不安・うつの関連性について

Relationship Between Changes in Fatigue and Physical Function, Anxiety, and Depression in Patients with Gastrointestinal Cancer in the Perioperative Period

要旨

【目的】周術期消化器がん患者に生じる倦怠感の変化とその関連要因を検討することを目的とした．

【方法】対象は消化器がん患者46例（男性25例，女性21例，年齢62.0±11.9歳）である．方法は倦怠感を評価するCFSの他にHAD，IKEF，6MWDを手術前・手術後・退院後で測定し，時期ごとでCFSと各評価の相関を調査した．

【結果】CFSは手術前が高値であり，経過を追うごとに減弱した．すべての時期でCFSは不安・うつに有意な正の相関，加えて手術前と退院後で6MWDとIKEFに有意な負の相関を認めた．

【結論】周術期消化器がん患者は手術前・手術後・退院後のすべての時期で倦怠感と不安・うつが関連し，さらに手術前と退院後で運動耐容能や膝伸展筋力が倦怠感に関係することが考えられた．手術前や退院後で運動機能に対する介入が倦怠感減弱に重要である可能性が示唆された．

Abstract

Objective：The purpose of this study was to investigate changes in fatigue and related factors in patients with gastrointestinal cancer in the perioperative period.

Methods：The study included 46 patients with gastrointestinal cancer (25 men and 21 women aged 62.0±11.9 years). The Cancer Fatigue Scale (CFS) was used to measure fatigue. The Hospitality Anxiety Depression scale (HAD) was used to measure anxiety and depression. The isometric knee extension force (IKEF) and 6-minute walk distance (6MWD) were used to measure physical function. These examinations were performed at three stages：before surgery, after surgery, and after discharge.

Results：CFS scores were high before surgery, and then gradually decreased across the stages. CFS scores were positively correlated with anxiety and depression at all three stages. Moreover, CFS scores were negatively correlated with 6MWD and IKEF before surgery and after discharge.

Conclusion：Fatigue was related to anxiety and depression at all three stages. In addition, fatigue was negatively correlated with exercise tolerance and IKEF before surgery and after discharge. It is suggested that an intervention for improving physical function is important to decrease fatigue before surgery and after discharge in patients with gastrointestinal cancer in the perioperative period.