End-stage renal disease (ESRD) is the final stage of chronic kidney disease. When kidney failure reaches a certain level, kidney replacement therapy is needed. At present, the total number of end-stage renal ESRD patients in China is about 1 million, which is a large number. At present, the main treatment methods are blood purification (hemodialysis, peritoneal dialysis) and kidney transplantation, which can prolong the survival of patients and improve the quality of life of patients. As we all know, dialysis is a maintenance treatment for the purpose of correcting some physiological indicators of the patient. When receiving hemodialysis, peritoneal dialysis and other alternative treatment for end-stage renal disease, attention should be paid to the precautions before, during and after hemodialysis.
1. Relax your mind, eliminate your fears, and face the disease positively.
2. The day before each dialysis should take a shower, change comfortable, clean, loose clothes, if any clothes, need to accurately weigh the weight of the clothes.
3. Before treatment, it is necessary to measure weight, blood pressure, breathing, pulse, so that doctors can formulate dialysis treatment orders according to patients' conditions.
4. Take the initiative to tell the doctor whether there is edema, urine volume is reduced, blood pressure control, whether there is palpitations, tightness, can not lie flat, diarrhea, fasting, etc., so that the doctor can set accurate water removal for you. Tell the doctor if there is any bleeding (mouth, nose, skin, eyes, urine and stool, menstrual period in women...) So that the doctor can set the appropriate type and dosage of anticoagulant for you.
5. In order to avoid cross-infection, the dialysis treatment room is not allowed to enter without permission during the treatment period.
6. Patients should bring elastic bandages and antihypertensive drugs according to their needs, and those prone to hypoglycemia should also bring candy, biscuits and other food.
7. Medical staff should also be informed of the use of special drugs (antihypertensive drugs, hypoglycemic drugs, hemostatic drugs, antiplatelet drugs), special treatments (blood transfusion, fat milk input, angiography, catheterization, etc.), and special conditions (abnormal body temperature, disturbance of consciousness, allergic history, etc.) before dialysis treatment.
1. During the treatment of nausea, vomiting, dizziness or headache, cramps, chest tightness, chest pain, cold sweating, skin itching, abdominal pain, back pain and other discomfort, should be reported to the medical staff as soon as possible for treatment.
2. If the need for drinking water cannot be controlled, it is best to use a measured cup to calculate the amount of drinking water during dialysis, so that the actual amount of water removed after dialysis can be better calculated.
3. If the patient has hunger, it is recommended to eat an appropriate amount of sugary foods and carbohydrates to prevent the occurrence of hypoglycemia.
4. In the process of dialysis, patients with internal fistula should avoid excessive movement of the limbs on the internal fistula side, so as not to damage the intima of the blood vessel, cause hematoma or cause the puncture needle slip. Patients with catheters should keep their limbs relatively fixed at the catheters to avoid machine alarm caused by insufficient blood flow.
5. Inpatients should avoid intravenous blood transfusion, hemostatic drugs, fat milk and antibiotics during dialysis. Blood transfusion, hemostatic agents and fat milk in dialysis can easily lead to blood coagulation during extracorporeal circulation. If the molecular weight of antibiotics transfused during dialysis is smaller than the dialysis membrane pore, part of antibiotics will be cleared by dialysis and the efficacy will be reduced. Unnecessary subcutaneous and intramuscular injections should be avoided during dialysis. The use of anticoagulants during dialysis, the patient's systemic heparinization, subcutaneous injection and intramuscular injection can easily lead to the formation of subcutaneous hematoma.
6. Because the dialysis time is relatively long, the patient can use music therapy to relieve tension: music can improve the patient's physical and mental health level, improve the patient's cognitive ability, social ability, relieve physical and mental pain.
7. During the dialysis process, patients with internal fistula can do simple activities of their lower limbs, and patients with catheter placement can read books, newspapers, etc., and spend the dialysis process in a leisurely and relaxed way.
1. Get up slowly after dialysis to prevent postural hypotension.
2. Take your blood pressure and weight and tell your doctor. It should be noted that the clothes worn when weighing after dialysis must be the same as before dialysis.
3. Patients with internal fistula should first wear the sleeves of the limbs on the internal fistula side, choose clothing with loose sleeves, and move slowly to prevent the puncture point from shifting the hemostatic cotton ball and bleeding.
4. Relax the compression bandage according to your own situation, and observe and feel whether there is bleeding at the puncture point of the internal fistula at any time. If the sleeve is wet or hot, it is necessary to be alert to bleeding at the puncture point. If there is bleeding on the road, press the puncture point and 0.5cm to 1cm near the heart immediately, so as not to bleed and can feel the vascular tremor.
5. Keep the puncture site dry for 24 hours, and apply some medicine to soften blood vessels and scars around the internal fistula after the puncture site heals.
6. At home, you should bring your own weight scale and keep track of your weight changes.
7. During dialysis patients should ensure adequate sleep, do not go to crowded places.
8. Usually more outdoor exercise, such as: walking, gymnastics, etc. can help relieve the psychological pressure of patients.
9. Internal fistula patients 2-3 times a day to detect the internal fistula, such as internal fistula tremor, noise disappeared, internal fistula tenderness or pain, should be treated in time.
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