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增加血流速率对血液透析患者尿毒症瘙痒严重程度的影响:一项单临床试验。

The Effect of Increasing Blood Flow Rate on Severity of Uremic Pruritus in Hemodialysis Patients: A Single Clinical Trial.

机构信息

Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran.

Clinical Cares and Skills Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Yasuj University of Medical Sciences, Yasuj, IR Iran.

出版信息

J Natl Med Assoc. 2018 Jun;110(3):270-275. doi: 10.1016/j.jnma.2017.04.008. Epub 2017 Jun 28.

Abstract

BACKGROUND

Although the prevalence of uremic pruritus has decreased compared to the past, the problem still remains as a matter of health and a major challenge of research in medical field, and has no effective treatment at present. This study aimed to investigate the effect of increasing blood flow rate on severity of uremic pruritus in hemodialysis patients in Iran.

METHODS

This clinical trial was performed on 60 hemodialysis patients that referred to hospitals affiliated to Tehran University of Medical Sciences and these patients were selected through the convenience method and were treated for four weeks. They were divided into two groups of experimental and control as random allocation block, and studied for 4 weeks. Information on pruritus severity was collected using a researcher-made questionnaire in three steps of before intervention and two and four weeks after start of intervention. The rate of blood flow was increased in the first two weeks and the second two weeks by 25 and 50 rounds per minute (rpm) compared to the mean rate of blood flow of hemodialysis device in the last two sessions before intervention. Data were analyzed using the tests Mann-Whitney, Fisher, and t-test.

RESULTS

Analysis of data from 50 persons in both groups who completed the study revealed a significant difference between the groups in the severity of pruritus between the two sessions of hemodialysis (pruritus at home) at the end of the first two weeks of the intervention (<0.05) and the number of cases of pruritus (<0.05) at the end of the study.

CONCLUSIONS

Increasing blood flow for hemodialysis machine can induce significant statistical and clinical reduction in the severity and the frequency of pruritus in hemodialysis patients and can be help to be improve the quality of life of these persons by increased the blood flow rate.

摘要

背景

尽管与过去相比,尿毒症瘙痒的患病率有所下降,但它仍是一个健康问题,也是医学领域研究的主要挑战,目前尚无有效的治疗方法。本研究旨在探讨增加血液流速对伊朗血液透析患者瘙痒严重程度的影响。

方法

本临床试验在德黑兰医科大学附属医院就诊的 60 名血液透析患者中进行,采用便利抽样法选取患者,并通过随机分配块将其分为实验组和对照组,各 30 例,治疗 4 周。在干预前和干预后 2 周及 4 周,使用研究者自制问卷收集瘙痒严重程度信息。在头两周和后两周,将血液流速分别比干预前最后两次血液透析设备的平均血流速度增加 25 转/分和 50 转/分。采用 Mann-Whitney、Fisher 和 t 检验对数据进行分析。

结果

对完成研究的两组各 50 名患者的数据进行分析,发现干预后第一、二周两次血液透析(家庭瘙痒)期间瘙痒严重程度和研究结束时瘙痒病例数存在显著差异(<0.05)。

结论

增加血液透析机的血流速度可显著降低血液透析患者瘙痒的严重程度和频率,可通过增加血流速度提高患者的生活质量。

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