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皮肤搔痒应急预案
透析患者常见不适症状，有时严重影响患者生活质量。
透析治疗会促发或加重症状。
1.寻找可能原因尿毒症患者皮肤瘙痒发病机制尚不完全清楚，与尿毒症本身、透析治疗及钙磷代谢紊乱等有关。
其中透析过程中发生的皮肤瘙痒需要考虑与透析器反应等变态反应有关。
一些药物或肝病也可诱发皮肤瘙痒。
2.治疗可采取适当的对症处理措施，包括应用抗组胺药物、外用含镇痛剂的皮肤润滑油等。
3.预防针对可能的原因采取相应的预防手段。
包括控制患者血清钙、磷和iPTH于适当水平，避免应用一些可能会引起瘙痒的药物，使用生物相容性好的透析器和管路，避免应用对皮肤刺激大的清洁剂，应用一些保湿护肤品以保持皮肤湿度，衣服尽量选用全棉制品等。
血液透析滤过治疗尿毒症皮肤瘙痒临床研究目的：观察血液透析滤过治疗尿毒症患者皮肤瘙痒的临床效果，并探讨其机制。
方法：选取2012年12月-2014年12月在笔者所在科室维持血液透析的尿毒症伴有皮肤瘙痒患者36例，随机将其分为血液透析组（HD组）和血液透析联合血液滤过组（HDF组），各18例。
HD组继续维持血液透析，HDF组在血液透析基础上联机应用血液滤过，每周2～3次，每次4 h，疗程为一个月。
检测治疗前后甲状旁腺激素（PTH）、血β2微球蛋白（β2-MG）水平，记录皮肤瘙痒症状缓解情况。
结果：治疗后，HDF组血中PTH、β2-MG水平均显著低于HD 组，而皮肤瘙痒症状缓解率明显高于HD组（P＜0.05）。
结论：规律血液透析联合血液滤过，能有效缓解尿毒症患者皮肤瘙痒症状。
[Abstract] Objective：To observe the clinical effect of blood dialysis filtration in the treatment of uremic patients with skin itching，and to explore its mechanism.Method：36 maintenance hemodialysis uremia patients with skin itching in our hospital from December 2012 to December 2014，they were randomly divided into the hemodialysis（HD）group and the hemofiltration（HDF）group，18 cases in each group.HD group continued maintenance hemodialysis，the HDF group based on the hemodialysis used blood filtration，2-3 times a week，each time 4 h，the course of treatment for a month.Before and after treatment，the parathyroid hormone（PTH）and serum β2 （β2-MG）levels were detected，the relief of skin itching symptoms was recorded.Result：After treatment，the levels of β2-MG，PTH in the HDF group were lower than those of the HD group，the remission rate of skin pruritus was significantly higher than that of the HD group（P＜0.05）.Conclusion：Regular hemodialysis combined with blood filtration can effectively alleviate the symptoms of skin itching in uremic patients.[Key words] Uremia；Skin pruritus；Hemodialysis；Hemofiltration皮肤瘙痒是尿毒症患者常见的并发症之一，严重影响尿毒症患者的生活质量，其发病机制较为复杂，一直是困扰尿毒症患者和医生的临床难题[1]。
维持性血液透析患者皮肤瘙痒相关发病机制及治疗研究进展作者：刘钊廖艳唐俊来源：《中国医学创新》2022年第15期【摘要】尿毒症患者一般需要进行维持性血液透析治疗，发生皮肤瘙痒的概率较高，大部分尿毒症患者会受到皮肤瘙痒的影响。
尿毒症患者皮肤瘙痒的成因复杂，本文将尝试探讨相关机制，总结相关病因，以期早日探明该病的发病机制。
目前，医疗水平在不断进步，已经有了许多治疗方法应对维持性血液透析患者皮肤瘙痒，药物、手术等多种治疗方法均可使患者获益。
本文总结了该病治疗研究进展，可能对提高该病治疗效果有一定的帮助。
【关键词】尿毒症维持性血液透析皮肤瘙痒发病机制Research Progress on Pathogenesis and Treatment of Skin Pruritus in Patients with Maintenance Hemodialysis/LIU Zhao， LIAO Yan， TANG Jun. //Medical Innovation of China， 2022， 19（15）： -174[Abstract] Patients with uremia generally need maintenance hemodialysis treatment， and the probability of skin pruritus is high， most uremia patients will be affected by skin pruritus. The causes of skin pruritus in patients with uremia are complex， this paper will try to explore the relevant mechanism and summarize the relevant etiology， in order to find out the pathogenesis of the disease as soon as possible. At present， the medical level is constantly improving， and there are many treatment methods to deal with the skin pruritus of maintenance hemodialysis patients. A variety of treatment methods such as drugs and surgery can benefit patients. This paper summarizes the research progress of the treatment of the disease， which may be helpful to improve the treatment effect of the disease.[Key words] Uremia Maintenance hemodialysis Skin pruritus PathogenesisFirst-author’s address：Zhongxiang People’s Hospital， Hubei Province， Zhongxiang 431900， Chinadoi：10.3969/j.issn.1674-4985.2022.15.041超过半数以上的维持性血液透析患者会受到皮肤瘙痒症状的困扰，发病时严重影响患者的工作和生活，对患者的生活质量造成巨大的影响。
2021年9月第7卷第27期No.27 Issue, Vol.7, September; 2021智慧健康Smart Healthcare13D0l：10.19335/ki.2096-1219.2021.27.005 .篾廉科学•篾麋沦塞•研窆分析尿毒症皮肤瘙痒用血液灌流与血液透析联合治疗的效果陈娜(广东省江门市五邑中医院血透中心，广东江门529000)摘要：目的探讨屎毒症皮肤瘙痒用联合方案治疗的效果，分析血液灌流与血液透析联合治疗的价值。
方法在广东省江门市五邑中医院血透中心2016年1月至2019年10月收治的尿毒症皮肤瘙痒患者中，选择当中的 82例患者当作研究对象，按随机数字法将病患进行分组，即对照组、研究组，分别接受血液透析、血液透析联 合血液灌流治疗。
对两组治疗效果中的甲状旁腺激素、皮肤瘙痒评分、肾功能进行比较。
结果观察组的治疗 总有效率更高，差异有统计学意义（P<0.05);两组的甲状旁腺激素、皮肤瘙痒评分治疗前差异无统计学意义 (尸>0.05)，治疗后观察组更低，差弁有统计学意义（尸<0.05) ;BUN、SCr、卩2—MG、Ca及P水平治疗前，差异 无统计学意义（P>0.05),治疗后观察组BUN、SCr、P2-M G及P更低，差异有统计学意义（户<0.05)，观察组 Ca水平更高，差异有统计学意义（尸<0.05)。
结论尿毒症皮肤癌•痒用血液灌流与血液透析联合治疗可增强治疗 效果，更好地改善瘙痒症状，促进甲状旁腺激素水平下降，进而改善预后，值得应用。
关键词：尿毒症；皮肤瘙痒；血液灌流；血液透析；甲状旁腺激素本文引用格式：陈娜.分析尿毒症皮肤瘙痒用血液灌流与血液透析联合治疗的效果⑴.智慧健康，2021,7(27):13-15_Effect Analysis of Hemoperfusion Combined WithHemodialysis in Treatment of Uremic Skin PruritusCHEN Na(Hemodialysis Center, Jiangmen City Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, Guangdong, 529000) ABSTRACT: Objective To explore effect of combined regimen on uremic skin pruritus and analyze value of combined therapy of hemoperfusion and hemodialysis. Methods The paper chose 82 patients with uremic skin pruritus treated in our hospital from January 2016 to October 2019 as research targets, and divided them into control group and study group according to random number method. They were treated with hemodialysis and hemodialysis combined with hemoperfusion respectively. Curative effect, parathyroid hormone, skin pruritus scores and renal function were compared between two groups.Results Total effective rate in observation group was higher (F<0.05); scores of parathyroid hormone and skin pruritus had no difference before treatment (P>0.05), those of observation group were lower after treatment (P<0.05); BUN, SCr,p2-MG, Ca and P levels showed no difference before treatment (尸>0.05), thosein observation group were lower after treatment, levels of BUN , SCr, p2-mg, Ca and P were lower after treatment (F<0.05), and Ca level in observation group was higher (F<0.05). Conclusion Combined treatment of hemoperfusion and hemodialysis can enhance curative effect for uremic skin pruritus, improve pruritus symptoms, promote decrease of parathyroid hormone level, and improve prognosis, which is worthy of application.KEYWORDS: Uremia; Skin itch; Hemoperfusion; Hemodialysis; Parathyroid hormone〇引言慢性肾衰竭指的是各种肾脏病造成肾脏功能出现 不可逆性减退，直到功能丧失所表现出的一系列症状 和代谢异常所组成的临床综合征，被称为慢性肾衰。
