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1、地塞米松预处理治疗血液透析患者皮肤瘙痒症的疗效观察林新伟*赵茹杨君摘要：目的了解地塞米松预处理透析器是否能缓解血液透析患者的皮肤瘙痒症。方法维持性血液透析伴发皮肤瘙痒症患者65例，随机分成对照组和地塞米松预处理组，地塞米松预处理组在透析治疗前用地塞米松40mg加入生理盐水250ml中，然后灌入透析器及血路管道中浸泡20分钟后排出，对照组按常规血透操作规程进行，每周透析3次，按上述治疗方法治疗12次后，评估疗效并观察预处理组治疗前后心率、血压及血糖的变化。结果透析器及血路管经地塞米松预处理后，皮肤瘙痒程度有明显改善，达
2、到完全缓解及部分缓解均比对照组明显升高，总有效率60%,p<0.01,两纽相比，差异具有显著统计学意义。皮肤瘙痒评分由治疗前14.71±4.22分降至治疗后的9.12±3.36分，前后比较具有显著统计学差界，p<0.001,地寒米松预处理前后的心率、血压及血糖也无明显的变化，经t检验无显著统计学差异（p>0.05）。结论地塞米松预处理透析器可以有效、安全改善血透患者的皮肤瘙痒，值得临床选择应用。关键词：地塞米松血液透析皮肤瘙痒殆作者单位：解放军第152屮心医院肾内科水通信作者：林新伟467000平顶山市，解放军第15
3、2中心医院肾内科，Email:weilin431@sina.comPretreatmentwithdexamethasonetreatmentforpatientswithhemodialysisprurituscurativeeffectobservationAuthor:Departmentofnephrology,The152ndCentralHospitalofPLA.LinXinWeiZhaoRuYangJunAbstract:Objectivetounderstandthedexamethasonepre
4、treatmentdialyzercanalleviatetheskinpruritusinhemodialysispatients.MethodHemodialysisassociatedwithpruritusinpatientswith65cases,wererandomlydividedintocontrolgroupanddexamethasonepretreatmentgroup,dexamethasonepretreatmentgroupatdialysisbeforetreatmentwithdexa
5、methasone40mgjoined250mlsaline,andthenpouredintothedialyzerandbloodpipelinesinthewaterfor20minutesafterthedischarge,thecontrolgroupreceivedconventionalhemodialysisoperatingrules,weeklydialysis3times,accordingtotheabovetreatmentsafter12timesoftreatment,assessmen
6、tofefficacyandobservationofpretreatmentgroupsbeforeandaftertreatment,heartrate,bloodpressureandbloodglucosechanges・ResultAblooddialyzerandpipebydexamethasonepretreatment,skinitchingwassignificantlyimproved,achievingacompleteremission,partialremissionthanthosein
7、thecontrolgroupwerehigher,thetotalefficiencyof62.86%,P<0.01,twogroupscompared,thedifferencehasstatisticalsignificanee.Theskinpruritusscorebypriortreatmentwith14.71+4.22to10.12+3.36minutesaftertreatment,andcomparedwiththesignificantdifference,P<0.001.Heartrate,b
8、loodpressureandbloodsugarhasnoobviouschangeindexamethasonepretreatmentgroup,pretreatmentandposttreatmentcomparisonofthettest,nosignificantdifferences(P>0.05).Conclusiondexam
