体外冲击波联合自体骨髓干细胞移植治疗股骨头缺血性坏死康复护理.docVIP

体外冲击波联合自体骨髓干细胞移植治疗股骨头缺血性坏死康复护理【摘要】目的：总结体外冲击波疗法（extracorporeal shock waves therapy，ESWT）联合自体骨髓干细胞移植治疗股骨头坏死的康复护理体会。方法：对26例早中期股骨头缺血性坏死的患者首先给予体外冲击波治疗再进行自体骨髓干细胞移植术。术前采用针对性心理干预，术后严格观察生命体征，积极预防并发症，加强康复训练的指导。结果：随访6－14个月，24例髋关节疼痛消失，2例髋部疼痛较术前减轻。结论：股骨头缺血性坏死联合自体干细胞移植术对早期股骨头缺血性坏死疗效显著，体外冲击波治疗期间和自体骨髓干细胞移植围手术期的整体护理可明显提高治疗效果，尤其心理护理及术后康复护理在治疗过程中发挥更为积极的作用 【关键词】股骨头缺血性坏死；体外冲击波；干细胞；护理 【中图分类号】R473.6 【文献标识码】A 【文章编号】1008-6455（2011）12-0014-02 【Abstract】Objective： Rehabilitation nursing of extracorporeal shock wave therapy （ESWT） combined with autologous bone marrow stem cell transplantation in treatment of femoral head necrosis. Methods：26 patients were in early and mid period of avascular necrosis.They were treated by ESWT before transplanted of autologous bone marrow stem cell. Preoperative specific psychological intervention was used, and the patients were gived strict observation of vital signs to prevent complications and the guidance of rehabilitation training. Result; Follow up 6 to 14 months, 24 cases of hip pain was disappeared and two cases of hip pain was to lessen. Conclusion: ESWT combined with autologous stem cell transplantation to cure early period of avascular necrosis avascular necrosis have significant effect. Overall care during ESWT and autologous bone marrow stem cell transplantation can improve the therapeutic effect. Especially, psychological care and postoperative rehabilitation care play a more active role in treatment. 【Key words】avascular necrosis of femoral head；extracorporeal shock waves therapy；stem cells； nursing care 股骨头缺血性坏死是各种原因所致股骨头内脂质堆积、多能干细胞成脂分化、股骨头内血供障碍等引起的一类疾病，多发于中青年，是一种常见的致残性疾病〖1, 2〗。近年来体外冲击波和自体骨髓干细胞移植技术为早中期股骨头缺血性坏死提供了良好的治疗方法〖3〗。现对在我科采用体外冲击波联合自体骨髓干细胞移植治疗股骨头缺血性坏死患者〖4〗，实施整体护理并取得满意效果的护理体会总结如下 1 资料与方法 1.1 一般资料:选择我科在2008年8月－2010年4月期间，行冲击波联合股骨头钻孔减压自体骨髓干细胞移植术后的的股骨头缺血性坏死患者26例，男性患者20例，女性患者8例；年龄19-48岁；病程4个月到5年；ARCO分期Ⅰ－Ⅲ期，其中I期18例，Ⅱ期10例，Ⅲ期5例；主要表现：患者髋部疼痛、麻木、伴活动受限或跛行 1.2 治疗方法 1.2.1 ESWI干预，应用骨科专用体外冲击波治疗机，进行干预，能量密度9-12KV HK_ESWD_AJ （10.16-0.22