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閉塞性動脈硬化症患者の自家末梢血幹細胞移植による血管再生医療の実際とそのケア
浦野, 昌子;渡邊, 翼;溝部, 佳代;松下, 通明
Permalink : http://hdl.handle.net/2115/35558
JaLCDOI : 10.14943/34004
KEYWORDS : Regenerative Medicine;Autologous Peripheral Blood Stem Cell Transplantation (PBSCT);Arteriosclerosis Obliterans (ASO);Informed Consent (IC);Nursing Care;再生医療;自家末梢血幹細胞移植（PBSCT）;閉塞性動脈硬化症（ASO）;インフォームドコンセント（IC）;看護
Abstract
目的：本研究の目的は、先進医療である再生医療の現状を把握し、再生医療を受ける今後の患者に対するケアの課題を検討することである。方法：2名の閉塞性動脈硬化症（ASO）患者に行われた自家末梢血幹細胞移植（PBSCT）療法と看護の実際を観察すると同時に、担当医、看護師、患者に直接聞き取り調査を行い、今後PBSCTを受ける患者へのケアのあり方を考察した。結果および考察：PBSCTにおける留意点として、G-CSF投与による副作用、末梢血幹細胞採取や多数の筋肉注射における合併症の熟知が必要と考えられ、副作用や合併症の発現を予防すると共に、十分な観察のもとこれらを早期発見する必要性が示唆された。患者・家族に対して、医師は期待される治療効果と起こりうる副作用について説明し［インフォームドコンセント（IC）］、看護師は必要に応じてIC内容の補足説明や再度のICの機会を設けるよう調整していた。患者らはIC内容を十分理解し得るようになっていたが、治療効果に期待する反面、治療効果がみられないかもしれない点に不安をもっていた。従って、医師・看護師は患者・家族へ正確な情報提供・ICと継続的な精神的支援を行うことが重要である。
Objective: The purpose of this research is to understand the current state of angiogenetic blood stem cell transplantation and to consider the issues of caring patients who will have a treatrnent of regenerative medicine. Methods: Details of the autologous peripheral blood stem cell transplantation (PBSCT) therapy to the two patients who were sufferingfrom arteriosclerosis obliterans (ASO), were observed precisely. Direct interviews to the physician in charge, the nurces in charge and the patients who received the treatrnent, were carried out to clarify the issues to be considered in caring the patients who undergo regenerative medical treatments in the future. Results and Discussion: Management in nursing care of PBSCT included side effectsin use of the granulocyte colony-stimulating factor (G-CSF), complications at the peripheral blood stem cell collection and at the intramuscular multiple injections of stem cells. The patients comprehended well the informed consent (IC) which was provided by the physician in charge, however, they felt the anxiety day by day for no therapeutic gain. Therefore, it is important that health care professionals have to provide accurate medical information, IC to a patient and have to support a patient consistently from a mental aspect.
Objective: The purpose of this research is to understand the current state of angiogenetic blood stem cell transplantation and to consider the issues of caring patients who will have a treatrnent of regenerative medicine. Methods: Details of the autologous peripheral blood stem cell transplantation (PBSCT) therapy to the two patients who were sufferingfrom arteriosclerosis obliterans (ASO), were observed precisely. Direct interviews to the physician in charge, the nurces in charge and the patients who received the treatrnent, were carried out to clarify the issues to be considered in caring the patients who undergo regenerative medical treatments in the future. Results and Discussion: Management in nursing care of PBSCT included side effectsin use of the granulocyte colony-stimulating factor (G-CSF), complications at the peripheral blood stem cell collection and at the intramuscular multiple injections of stem cells. The patients comprehended well the informed consent (IC) which was provided by the physician in charge, however, they felt the anxiety day by day for no therapeutic gain. Therefore, it is important that health care professionals have to provide accurate medical information, IC to a patient and have to support a patient consistently from a mental aspect.
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