摘要
目的对慢性瘙痒患者的客观体征与主观症状进行相关性分析,进一步探索更全面的瘙痒症状管理方案。方法收集原发性皮肤炎性疾病慢性瘙痒患者150人。由医护人员完成客观体征评价,包括皮肤生理功能检测、皮损评分。主观症状指标评价来自患者自评,包括生命质量评价(简明健康状况调查表SF-36和皮肤病生命质量指数DLQI)和瘙痒视觉模拟评分(visual analogue scale,VAS)。结果 SF-36和DLQI呈正相关,二者与临床皮损评分之间存在负相关,与VAS负相关,但VAS评分和皮损评分之间相关性不具有统计学意义。表皮脂质、表皮含水量和皮损评分、VAS评分之间均呈负相关,红斑指数与皮损评分、VAS评分之间均呈正相关,经表皮失水率与SF-36及DLQI生命质量评价均呈负相关。结论皮损严重程度和瘙痒程度均损伤患者生命质量,但皮疹和瘙痒体验之间存在不一致性。皮肤生理功能损伤越重,患者瘙痒感越明显,生命质量体验越差,可以更客观反映皮肤亚临床变化。对瘙痒的评估内容应包含主观体征和客观指标,重视对皮肤生理功能的检测,为实施症状管理提供依据,奠定治疗护理方案个体化的基础。
Objective Analyze the correlation between objective signs and subjective indicators of chronic pruritus patients to further explore a more comprehensive management program of pruritus symptoms. Methods 150 patients with chronic pruritus were collected. Objective physical signs were evaluated by medical staff, including skin physiological function test and skin lesion score. The subjective evaluation comes from patients’ self-evaluation, including quality of life(The MOS item short from health survey SF-36 and dermatology life quality index DLQI) and visual analogue scale(VAS). Results F-36 and DLQI were positively correlated. There was a negative correlation between SF-36, DLQI and clinical skin lesion score, and a negative correlation with VAS, but there was no statistical significance between VAS and skin lesion score. Sebum and capacitance were negatively correlative to skin symptom score and VAS. There was a positive correlation between erythema index and skin lesion score, VAS. There was a negative correlation between transepidermal water loss and SF36, DLQI. Conclusion Both the severity of skin lesions and the degree of pruritus damage the patients’ quality of life, but there is inconsistency between the rash and the pruritus experience. The more serious the damage of skin physiological function, the more obvious the itch feeling and the worse the experience of life quality, can reflect the subclinical changes of skin more objectively. The evaluation of pruritus should include subjective signs and objective indicators, pay attention to the detection of skin physiological functions, then provide basis for the implementation of symptom management, and lay the foundation for individualized treatment and nursing programs.
作者
李娜
涂颖
熊英
能亚杰
LI Na;TU Ying;XIONG Ying;NENG Ya-jie(Dermatology Department,the 1st Affiliated Hospital of Kunming Medical University,Kunming,Yunnan 650032)
出处
《皮肤病与性病》
2020年第4期471-474,共4页
Dermatology and Venereology
基金
云南省科技计划项目应用基础研究(昆医联合专项),项目编号2017FE468(-048)。
关键词
瘙痒
症状管理
体征
症状
Pruritus
Symptom management
Signs
Symptoms
