48例尿毒症患者皮肤瘙痒症的透析模式分析及护理

目的探讨在规范的护理措施基础上选择血液透析（Hemodialysis，HD）＋血液透析滤过（Hemodiafiltration，HDF）模式相比单纯HD模式对改善尿毒症患者顽固性皮肤瘙痒的优势。方法选择尿毒症伴皮肤瘙痒患者48例，随机将其分为观察组和对照组，每组24例，观察组患者采取血液透析HD＋血液透析滤过HDF，对照组实施单纯HD，同时规范护理措施。治疗3个月后检测甲状旁腺激素和血β2-微球蛋白，并采用皮肤瘙痒临床症状评分法评估瘙痒程度。结果观察组患者治疗3个月后血β2-微球蛋白（β2-microglobulin，β2-MG）、甲状旁腺激素（Parathyroidhormone，PTH）水平均明显低于对照组（P〈0．01），皮肤瘙痒程度明显轻于对照组（P〈0．01）。结论采用血液透析＋血液透析滤过模式，并重视临床护理干预，能更有效地缓解尿毒症患者顽固性皮肤瘙痒症状。

Analysis of Dialysis Mode and Nursing of Skin Pruritus in 48 Patients with Uremia

Objective To investigate the effect of hemodialysis and hemodiafiltration with quality nursing care on improving uremic pruritus. Methods 48 patients with uremic pruritus were randomly divided into observation group （HD＋HDF） and control group （HD）, following quality nursing care. After treatment of 3 months, to detect parathyroid hormone （PTH） and β2-microglobulin （β2-MG）, and scores of puritus were recorded. Results After treatment of 3 months, the blood β2-MG, PTH levels had significant difference in two groups. But the effect of observation group was better than control group. The pruritus scores in observation group were lower than the control group, the difference was statistically significant （P〈0.01）. Conclusion With positive clinical nursing intervention, the treatment mode of HD＋HDF can more significantly reduce the obstinate itch of skin in uremia patients.