58例慢性肾功能衰竭合并皮肤瘙痒患者分析

Analysis on 58 Cases of Chronic Renal Failure combined with Uremic Pruritus

目的调查分析慢性肾功能衰竭患者皮肤瘙痒的部位、程度、治疗情况及皮肤瘙痒对其生活质量的影响程度。方法对某院血液净化中心58例慢性肾功能衰竭患者的皮肤瘙痒部位及治疗情况进行调查,以视觉模拟评分法评估瘙痒程度,并对其进行皮肤病生活质量(DLQI)评分。结果 58例慢性肾功能衰竭患者中轻度、中度、重度瘙痒分别为21例(34.2%)、23例(39.7%)、14例(24.1%);合并皮肤感染5例。患者DLQI评分平均7.72±1.61,皮肤瘙痒对生活质量影响最显著的是症状与感受(50%),其次为工作和学习(40.67%)。58例患者中有38例患者接受血液灌流和(或)血液透析滤过治疗后症状缓解。18例患者接受皮肤科专科治疗,其中12例给予单纯局部对症治疗,瘙痒缓解不明显;6例给予口服及外用药物治疗,治疗效果较单用外用药物为好。结论规律血液灌流和(或)血液透析滤过治疗能有效地缓解慢性肾功能衰竭患者皮肤瘙痒,提高患者生活质量。

Objectives To analyze the position,degree and treatment condition of uremic pruritus in patients with chronic renal failure as well as investigate its impact on the life quality of the patients.Methods To conduct a survey on the position and treatment condition of uremic pruritus of 58 cases of chronic renal failure in the blood purifying center of a hospital,then evaluated their degree of pruritus by visual analogue scale and made score of dematopathya life quality on them.Results There were 21 （34.2％） cases with mild pruritus in the 58 cases of chronic renal failure patients,while moderate degree was 23（39.7％）cases,serious degree was 14 （24.1％）cases,and 5 cases combined with skin infection.The DLQI score was 7.72 ± 1.61.The most significant effect on the life quality of patients was sensation （50％）,and then were work and study （40.67％）.38 CRF patients with prutitus were received hemoperfusion and/or hemodiafiltration and their symptoms relieved.18 patients with prutitus visited the department of dermatology,in which 12 of them received merely local symptomatic treatment,but the therapeutic effect was poor; 6 patients received internal combined with external drug therapy,and got better results than single external drug treatment.Conclusions Regular hemoperfusion and/or hemodiafiltration could alleviate the uremic pruritus of chronic renal failure patients and improve their life quality.