背景：癌因性疲乏是癌症患者，尤其是接受放化疗的患者最常见、痛苦且持续存在的一种症状，被广大学者所关注。妇科恶性肿瘤患者癌因性疲乏发病率高、程度重且持续时间长，可持续至治疗结束后数年。癌因性疲乏对癌症患者有破坏性的影响，可降低其生活质量、加重抑郁、焦虑等负性情绪，严重时甚至会影响患者的治疗依从性。研究表明，有氧运动可以保持甚至增强患者的身体机能、缓解癌因性疲乏、改善患者的精神状态和生活质量。国内目前对妇科恶性肿瘤化疗患者进行运动干预的研究较少，且无系统性、个体化的干预方案，因此，有必要探讨系统的、个体化的运动干预对妇科恶性肿瘤化疗患者癌因性疲乏的干预效果，为今后该人群的相关研究提供可借鉴的依据。

目的：探讨运动干预对妇科恶性肿瘤化疗患者癌因性疲乏的干预效果并评价干预过程的有效性。

方法：类实验性研究。研究者于2017年5月至2018年1月采取便利抽样方法，选取在北京协和医院妇科肿瘤二、三病房确诊并住院化疗的妇科恶性肿瘤化疗患者，共96例。按就诊时间分为干预组和对照组各48例。在常规护理的基础上，对干预组研究对象进行运动干预，干预内容包括健步走和弹力带抗阻运动，根据患者的治疗和身体情况，制定个体化的运动方案、督促方案的实施和定期收集运动日记。干预形式包括在院干预、电话随访和微信平台随访。在院干预5次；电话督导每周至少1次；微信平台沟通督导每周至少2次；运动日记每周记录4次。对照组在给予常规化疗护理外，讲解CRF知识，发放健康教育手册、运动小册子及运动日记。两组研究对象均分别在每个疗程开始前接受癌因性疲乏的调查和6分钟步行试验，在整个干预结束后通过“运动干预过程”评价表对干预过程进行评价。

结果：共完成90例研究对象的资料收集，干预组和对照组各45例。两组研究对象的癌因性疲乏水平均随着时间不断上升，但干预组上升幅度小于对照组，且干预结束后干预组研究对象的整体、感觉维度及认知情绪维度的癌因性疲乏水平均低于对照组，差异有统计学意义（P＜0.01）。两组研究对象的步行总距离均随着时间不断下降，但干预组下降的幅度小于对照组，且干预结束后干预组的6分钟步行总距离高于对照组，两组差异有统计学意义（P＜0.01）。干预组研究对象6分钟步行试验后疲劳程度低于对照组，但差异没有统计学意义（P＞0.01）。

结论：结合健步走和弹力带抗阻运动的运动干预可以有效缓解妇科恶性肿瘤化疗患者的癌因性疲乏并延缓因癌症和化疗导致的运动能力的降低。

Background: As one of the most common, distressful and persistent symptoms in cancer patients receiving chemotherapy and/or radiotherapy, cancer-related fatigue (CRF) is of high-incidence, prolonged and even could last for several years after the completion of anti-cancer treatment. CRF could decrease patients’ quality of life, aggravate anxiety and depression, in addition, it could even affect patients’ adherence to treatment. Previous researches indicated that aerobic exercise can alleviate patients’ CRF, enhance physical function, improve mental status and quality of life. However, there’s few systematic researches. Thus, it’s meaningful to explore the effect of exercise intervention on CRF in gynecological cancer patients.

Objectives: To investigate the effect of exercise intervention on CRF in gynecological cancer patients receiving chemotherapy.

Methods: A quasi-experimental study was conducted. A convenient sample of 96 women firstly diagnosed with gynecological cancer patients requiring chemotherapy from Peking Union Medical College Hospital was enrolled. They were divided into intervention group (N=48) or control group (N=48) according to the time sequence of admission. Both groups were provided with health education about CRF besides usual care. Pamphlets about exercise intervention and exercise diary were distributed. Besides,the intervention group was provided exercise intervention, combing brisk walking and elastic band resistance exercise in the hospital before every chemotherapy circle. Follow-up phone calls and Wechat were conducted every week. Data were collected before every circle of chemotherapy and 6 measuring points were included. Outcome measures were CRF and exercise capacity that was reflected through post-test patient-reported fatigue and 6-minute walk distance (6MWD).

Results: 90 women completed data collection, 45 women in intervention group and 45 in control group. CRF in total and four dimensions were analysed respectively. Fatgiue level in both groups ascended constantly, nonetheless with smaller scope in the intervention group. After the competition of intervention, CRF in intervention group was significantly lower than control group（P＜0.01）. Similiarly, 6MWD in both groups descended continuously with the smaller scope in intervention groups. After the intervention, 6MWD in intervention group was significantly longer than control group（P＜0.01）.However, there were no statistically significant differences in post-test patient-reported fatigue （P＞0.01）.

Conclusion: Exercise intervention can reduce CRF in gynecological cancer patients receiving chemotherapy and slow the decrease of exercise capacity caused by cancer and chemotherapy.