Dialysis makes the skin pruritus that is intolerable, how sh2018-02-09 16:51
Itching is not life-threatening, but it seriously affects the quality of life. Here's how to treat itching on dialysis, and how to do it.
There are a number of reasons for pruritus in dialysis patients:
The skin is dry. In the autumn and winter seasons, the skin will be dry and lack of moisture. The drying of hemodialysis patients will be more severe than that of the normal people, because the daily need for hemodialysis to limit drinking water, "soakage" without moisture, together with dialysis dehydration, makes it easier to dry the skin, especially after each dialysis is over.
Suggestions: pay attention to the daily skin care, because the itchiness of the skin is often aggravated when the skin is warm and hot, the water temperature should not be too high when taking a bath, you can use some warm and moisturizing bath liquid, Avoid alkaline soap. Apply a moisturizing lotion quickly after the bath, when the skin pores open to absorption, the effect will be better. For example: olive oil, glycerin, soothing moisturizing condensate, Vitamin E lotion and hydration spray can keep the skin moist.
Toxin accumulation. Although hemodialysis clears some of the toxins in the body, they are still far worse than normal kidneys. Ordinary dialysis can only remove some small molecular toxins, such as some medium and large molecular toxins, which cannot be eliminated. For example: β-2-microglobulin, parathyroid hormone, homocysteine and so on, these toxins accumulate in the body, can also cause skin itching.
Suggestions: if conditions permit, you can increase the number of dialysis, try to ensure that 3 / week dialysis. Can do appropriate amount of high pass dialysis or hemofiltration, perfusion, to clear the body of macromolecular toxins.
Calcium and phosphorus metabolism disorder. Calcium and phosphorus imbalance is more common in dialysis patients. Because of the decrease of phosphorus excretion, many patients' blood phosphorus is on the high side, which has not been well controlled. After a long period of time, it leads to the increase of PTH, the increase of blood calcium, and the increase of blood calcium in patients with secondary hyperparathyroidism and hyperparathyroidism. Calcium deposits in blood vessels and skin, not only cause skin itching, but also may cause ectopic calcification.
Suggestions: when PTH rises to a certain level and cannot be controlled with drugs, surgical excision is required. Problems such as a large amount of calcium supplementation after surgery can also bring a certain burden to the family. Daily control of calcium and phosphorus levels is very important. Limit the intake of phosphorus in the diet, take care not to eat foods that are high in phosphorus, such as animal offal, nuts, chocolate, etc., and chew phosphorus binders in meals. When PTH is too high, depending on the level of calcium and phosphorus, Perform shock therapy, etc.
In addition to the above, we should also pay attention to psychological nursing interventions. Patients with hemodialysis suffer from skin itching for a long time, slow treatment, prolonged treatment, anxiety, irritability, depression, pessimism. And this series of psychological problems, Can pruritus symptom aggravation, even affect sleep quality.