摘要
目的探讨细节护理干预对采用血液透析联合血液灌流治疗的尿毒症患者并发的皮肤瘙痒的缓解效果。方法选取2018年5~11月在盐城市第一人民医院治疗的尿毒症性皮肤瘙痒且行血液透析联合血液灌流(HD+HP)的方式治疗的门诊患者62例,随机分为观察组Ⅰ(16例),观察组Ⅱ(15例)和对照组(31例)。观察组Ⅰ采用心理干预的细节护理干预,观察组Ⅱ采用细节护理干预,对照组采用常规护理。比较三组患者治疗前后汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)的评分变化、皮肤瘙痒缓解情况及皮肤感染情况。结果护理前,三组患者HAMD、HAMA评分、瘙痒程度比较差异无统计学意义;护理后观察组Ⅰ、观察组Ⅱ、对照组的患者HAMD、HAMA评分均有下降,皮肤瘙痒情况均有一定缓解。其中观察组Ⅰ评分下降最多,瘙痒情况缓解最为明显,观察组Ⅱ次之,对照组与两组观察组效果相差明显,差异有统计学意义(P<0.05);皮肤感染观察组Ⅰ与观察组Ⅱ比较差异无统计学意义,对照组皮肤感染率均低于观察组,差异均有统计学意义(均P<0.05)。结论对正在进行血液透析联合血液灌流治疗的尿毒症患者,采用针对性的细节护理干预能进一步减轻患者的皮肤瘙痒情况,护理过程中及时的心理干预,对患者症状的缓解也有一定的帮助作用。
Objective To explore the effect of detailed nursing on the relief of pruritus in uremia patients treated with hemodialysis combined with hemoperfusion.Methods Sixty-two outpatients with uremic pruritus(UP)treated by hemodialysis combined with hemoperfusion(HD+HP)in the hospital from May to November 2018 were selected as the study subjects.Patients were randomly divided into observation groupⅠ(16 cases),observation groupⅡ(15 cases)and control group(31 cases).The observation groupⅠadopted the detailed nursing intervention of psychological intervention.The observation groupⅡadopted the detailed nursing intervention.The control group adopted the routine nursing.The changes in the scores of Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA),relief of itching and skin infection before and after treatment were compared among the three groups.Results Before nursing,there was no statistically significant difference in HAMD,HAMA scores and itch degree among the three groups.HAMD and HAMA scores of patients in the observation groupⅠ,observation groupⅡand control group decreased after nursing,and itchy skin conditions were alleviated to some extent.In the observation groupⅠ,the score decreased the most,and the itch relief was the most obvious,followed by the observation groupⅡ.The effects of the control group and the two observation groups were significantly different,and the difference was statistically significant(P<0.05).There was no significant difference in skin infection between observation groupⅠand observation groupⅡ.The skin infection rate in the control group was lower than that in the observation group,and the difference was statistically significant(P<0.05).Conclusions For uremic patients undergoing hemodialysis combined with hemoperfusion treatment,specific detailed nursing intervention can further reduce the skin itching of patients.Timely psychological intervention in the nursing process can also help relieve the symptoms of patients to some extent.
作者
杨海棠
Yang Haitang(Department of Blood Purification Center,Yancheng First People's Hospital,224001,China)
出处
《国际护理学杂志》
2020年第20期3659-3663,共5页
international journal of nursing
基金
江苏省卫计委科研课题(Z2017015)。
关键词
尿毒症皮肤瘙痒
细节护理干预
血液透析
血液灌流
心理干预
Uremic pruritus
Detailed nursing intervention
Hemodialysis
Hemoperfusion
Psychological intervention
