血液透析联合血液灌流对尿毒症患者皮肤瘙痒的疗效观察及护理

目的 探讨血液透析（HD）联合血液灌流（HP）对尿毒症患者皮肤瘙痒的治疗效果及护理.方法 选择尿毒症皮肤瘙痒患者30例,随机分为2组：HP＋ HD组15例,常规HD每周8h,HP＋HD每周4h;血液透析滤过（HDF）＋ HD组15例,每周常规HD治疗8h,HDF每周治疗4h.治疗12周后观察血尿素氮（BUN）、肌酐（SCr）、血清钙（Ca2＋）、血清磷（P3-）、甲状旁腺激素（PTH）的变化以及患者皮肤瘙痒缓解情况.结果 HP ＋HD组患者皮肤瘙痒的缓解率87％,高于HDF＋ HD组（67％）,且差异有统计学意义（P＜0.05）;HP＋HD组血P3-、PTH较HDF＋HD组下降明显（P＜0.05）;但BUN、SCr的下降程度2组间差异无统计学意义（P＞0.05）.结论 HP＋ HD能有效治疗尿毒症患者皮肤瘙痒且优于HDF＋ HD.

Clinical trial and nursing care of skin itch in uremia patients undergoing hemodialysis combined with hemoperfusion

Objective To probe the curative effect of hemodialysis（HD） combined with hemoperfusion（HP） on skin itch and nursing care in patients with uremia. Methods A total of 30 cases of uremia with skin itch were randomly assigned to hemodialysis combined with hemoperfusion group（ HD ＋ HP group,n = 15） and hemodiafiltration（HDF） combined with he- modialysis group （ HDF ＋ HD group, n = 15 ）. 8 hours conventional HD was performed every week in all the patients. In plus, 4 hours HD ＋ HP every week in HD ＋ HP group and 4 hours HDF in HDF ＋ HD group were carried out. Duration of the treatment was 12 weeks. The levels of blood urea nitrogen （ BUN）, serum creatinine （ SCr）, serum calcium, serum phosphorus （p3-） and parathyroid hormone （PTH） were measured and the status of skin itch was observed before and after treatment. Results The remission rate of skin itch in HP ＋ HD group was 87% ,it was higher than that in HDF ＋ HD group（67% ）, the difference was statistically significant （ P 〈 0.05 ）. Moreover, the decreases of p3- and PTH levels in HP ＋ HD group were obvious than that in HDF ＋ HD group（ P 〈0.05）. But there were not statistically significant differences about the de- creases of BUN and SCr levels between the two groups（P 〉 0.05）. Conclusion HP ＋ HD can effectively improve the skin itch in patients with uremia as compared to HDF ＋ HD.