维持性血液透析并发皮肤瘙痒症的危险因素与护理对策研究
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摘要
目的探讨维持性血液透析患者并发皮肤瘙痒症的危险因素与护理对策。方法选取2015年6月至2018年5月我院收治的维持性血液透析患者128例为研究对象,其中85例患者发生皮肤瘙痒,瘙痒程度:轻度27例,中度42例,重度16例;分析其并发皮肤瘙痒的相关因素并探讨护理对策。结果两组患者相关因素比较显示,血磷含量、钙磷乘积、平均年龄、透析时长、皮肤干燥患病率、透析前血肌酐含量、血红蛋白含量、甲状旁腺激素含量和每周透析过滤次数比较差异有统计学意义(P <0. 05)。多因素logistic回归分析显示,年龄、透析时长、皮肤干燥患病率、血磷含量、钙磷乘积、甲状旁腺激素含量、每周透析过滤次数是维持性血液透析患者并发皮肤瘙痒症的独立危险因素(P <0. 05)。结论分析维持性血液透析患者并发皮肤瘙痒症的危险因素可有效指导临床护理干预,缓解其瘙痒症状,改善预后。
Objective To explore the risk factors and nursing strategies for pruritus in patients with maintenance hemodialysis. Methods To select 128 patients with maintenance hemodialysis who were admitted to our hospital from June 2015 to May 2018 as the study subjects. Among them,a total of 85 patients had pruritus. The degree of itching was mild in 27 cases,moderate in 42 cases,and severe in 16 cases. We analyzed the related factors of concomitant skin itching and explored the nursing strategies. Results Analysis of correlation of factors between the two groups showed that there was statistical significance in the differences of blood phosphorus content,calcium-phosphorus product,average age,dialysis duration,skin dryness prevalence,pre-dialysis serum creatinine,hemoglobin content,parathyroid hormone content,and weekly dialysis filter times( P < 0. 05). Multivariate logistic regression analysis showed that age,dialysis duration,skin dryness prevalence,blood phosphorus content,calcium-phosphorus product,parathyroid hormone content,and weekly dialysis filter times were independent risk factors for pruritus in patients with maintenance hemodialysis( P < 0. 05). Conclusion Analysis of risk factors for pruritus in patients with maintenance hemodialysis can guide clinical nursing intervention effectively. Meanwhile,it can relieve itching symptoms and improve prognosis of the patients.
Objective To explore the risk factors and nursing strategies for pruritus in patients with maintenance hemodialysis. Methods To select 128 patients with maintenance hemodialysis who were admitted to our hospital from June 2015 to May 2018 as the study subjects. Among them,a total of 85 patients had pruritus. The degree of itching was mild in 27 cases,moderate in 42 cases,and severe in 16 cases. We analyzed the related factors of concomitant skin itching and explored the nursing strategies. Results Analysis of correlation of factors between the two groups showed that there was statistical significance in the differences of blood phosphorus content,calcium-phosphorus product,average age,dialysis duration,skin dryness prevalence,pre-dialysis serum creatinine,hemoglobin content,parathyroid hormone content,and weekly dialysis filter times( P < 0. 05). Multivariate logistic regression analysis showed that age,dialysis duration,skin dryness prevalence,blood phosphorus content,calcium-phosphorus product,parathyroid hormone content,and weekly dialysis filter times were independent risk factors for pruritus in patients with maintenance hemodialysis( P < 0. 05). Conclusion Analysis of risk factors for pruritus in patients with maintenance hemodialysis can guide clinical nursing intervention effectively. Meanwhile,it can relieve itching symptoms and improve prognosis of the patients.
引文
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[2]李玉慧.高通量血液透析对维持性血液透析患者皮肤瘙痒及生活质量的影响[J].护理实践与研究,2017,14(9):47-48.
[3]王丹.单次延长血液透析滤过时间对钙磷清除的疗效及对皮肤瘙痒的改善[D].西宁:青海大学,2017.
[4]许碧琴.针对性护理在维持性血液透析患者皮肤瘙痒中应用的效果观察[J].中外医学研究,2018,16(7):98-99.
[5]陆春霞.维持性血液透析老年患者皮肤瘙痒的临床护理[J].临床医药文献电子杂志,2017,4(98):19348,19350.
[6]刘广敏,陆晓艳,黄春香,等.217例维持性血液透析患者皮肤瘙痒情况及影响因素分析[J].中国中西医结合肾病杂志,2017,18(7):624-625.
[7]涂曦文,陈景,唐东兴,等.维持性血液透析患者皮肤瘙痒相关因素分析[J].吉林医学,2016,37(10):2496-2498.
[8]彭国辉,刘芙蓉.个性化护理对中药熏洗治疗血液透析患者皮肤瘙痒及满意度的影响[J].护理实践与研究,2018,15(1):39-41.
[9]吴雪红.维持性血液透析患者顽固性瘙痒的原因分析及护理对策[J].广西中医药大学学报,2015,17(4):108-110.
[10]肖萍.探讨维持性血液透析患者并发皮肤瘙痒症的护理经验[J].当代医学,2016,22(3):105-106.
[11]郭婧,屠恩玲.维持性血液透析患者皮肤瘙痒的原因分析及护理对策探讨[J].河北医学,2015,20(12):2106-2108.