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K. Toyofuku et al.

（和文抄録）

胃切除後 6ヶ月間における胃癌患者の食行動および，

身体的・精神的状態の変化

1)

九州大学大学院医学系学府 保健学専攻，

2)

福岡女学院看護大学

3)

産業医科大学 産業保健学部看護学科，

4)

福岡看護大学

5)

佐賀県医療センター好生館 消化器外科

6)

九州大学大学院 臨床・腫瘍外科，

7)

福岡赤十字病院 外科

8)

九州大学大学院医学研究院 保健学部門

豊 福 佳 代1)2)，永 松 有 紀1)3)，宮 園 真 美4)，田 中 聡 也5)，森 山 大 樹6)，

藤 原 謙 次6)，大内田研宙6)，永 井 英 司7)，中 村 雅 史6)，樗 木 晶 子8)

【目的】胃切除術を受けた胃癌患者の術後半年間における食行動，身体的状態およびうつ傾向の実態と

それらの関連を明らかにすることである．

【方法】胃癌で胃切除術を受けた患者を対象に，食行動，術後機能障害（DAUGS），抑うつ（CES-D）

に関する質問紙調査を，術後半年の間に 5 回（退院前，術後 2 週間，6 週間，3ヶ月，6ヶ月）縦断的に

実施した．各項目の経時的変化は反復測定分散分析を用い，患者要因と術後機能障害の関連は二元配

置分散分析を用いて検討した．抑うつと術後機能障害の関連は，相関関係を用いて分析した．

【結果】64 名の胃切除術後患者を対象とした．平均年齢 66.5（SD10.3）歳，男性 40 名であった．幽門

側胃切除術 46 名で，胃癌ステージⅠが 53 名であった．体重は術後半年間で約 10％減少した（p ＜

.001）

．術後半年経つと，食事量調整などの食行動を実践している人は 8 割から全体の半数に減少し

たが，食事摂取量は術前の 8 割程度に回復した．術後機能障害（DAUGS）は術後 2 週間が最も強く，

その後半年間で有意に改善した（p ＜.05）．患者要因による DAUGS 得点の推移を見ると，就労群と

高抑うつ群の機能がより障害されていた．高抑うつ群の術後機能障害の程度は，低抑うつ群と比べ，

6 か月間を通じて重かった．

【結論】胃切除後の機能障害は退院直後が最も悪く，6ヶ月間で軽快し，身体的状態と抑うつ状態が関

係していることが明らかになった．医療者は，入院中から患者の抑うつ状態を把握し，術後早期から

の胃切除術後機能障害の継続的な観察を行う必要がある．

キーワード：胃癌，胃切除後機能障害，抑うつ，食行動，縦断研究

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