心理干预对血液透析治疗的尿毒症患者负面心理和皮肤瘙痒的影响

Effects of psychological intervention on the negative emotions and uremic pruritus as a result of treatment with L-carnionc plus hemodialysis

目的探讨心理干预对左卡尼丁联合血液透析治疗的尿毒症患者负面心理和皮肤瘙痒的影响。方法采用随机数字法将94例左卡尼丁联合血液透析治疗的尿毒症患者分为对照组(n=46)和干预组(n=48),对照组给予常规护理,干预组常规护理加以心理干预。运用心身症状自评量表(SCL-90)、Znug焦虑自评量表(SAS)、Znug焦虑自评量表(SDS)评价干预效果;并比较两组患者治疗前后皮肤瘙痒改善情况。结果对照组总有效率显著低于干预组(69.56%VS93.75%,χ2=9.274,P=0.002);干预前,两组患者的SCL-90各项心理因子,SAS、SDS标准分无组间差异(P>0.05),干预后,干预组SCL-90各项心理因子得分均显著低于对照组(均P<0.05),SAS、SDS标准分在干预2周以及4周后显著低于对照组(均P<0.05)。结论在左卡尼丁联合血液透析治疗尿毒症患者的过程中,给予心理干预,能够明显减轻皮肤瘙痒症状、明显消除负面情绪,提高患者生存质量。

Objective To understand the effects of psychological intervention on the negative emotions and uremic pruritus resulting from treatment with a combination of L-carnionc and hemodialysis. Method 94 patients with uremic admitted to our hospital from December 2009 to October 2013 were divided into two groups randomly. The control group（ n = 46） were treated with L-carnionc plus hemodialysis and current nursing; The experimental group（ n = 48） were treated with psychological intervention in addition to the treatment provided to the control group. The effects of the intervention was evaluated according to SCL-90,SAS and SDS; The symptoms of uremic pruritus of the two groups before and after treatment were compared. Findings The total effective rate of the control group was considerably lower than that of the experimental group（ 69. 56% VS 93. 75%）. The difference had statistical significance（ χ2= 9. 274,P = 0. 002）. Before intervention, there was no statistical difference in SCL-90,SAS and SDS between the two groups（ P 0. 05）. After intervention,thepsychological factors of SCL-90 of the experimental group was significantly lower than those of the control group（ P 0. 05）. Further more,the standard score of SAS and SDS of patients in the experimental group both were significantly lower than those in the control group after 2 and 4 weeks＇ intervention（ P 0. 05）. Conclusion The study Findings shows that psychological intervention can significantly reduce negative emotions and uremic pruritus resulting from treatment with Hemodialysis plus L-carnionic.