关键词: 尿毒症, 终末期肾病, 血液透析, 腹膜透析, 皮肤瘙痒, 循证护理

Abstract: Objective To evaluate and summarize the evidence of management of skin pruritus in uremic patients, and to provide reference for clinical practice. Methods We searched UpToDate, National Institute for Health and Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), National Guideline Clearinghouse (NGC), www.Medlive.cn, BMJ Best Practice, Cochrane Library, JBI Evidence-based Health Care International Collaborating Center Library, Guideline International Network (GIN), International Society of Nephrology (ISN), PubMed, CINAHL, Embase, Web of Science, ScienceDirect, CNKI, Wanfang Database, CBM, and VIP Database to collect evidence on management for patients with uremic pruritus (UP). The retrieval period was from the inception of the databases to February 2022. Two researchers with evidence-based nursing background assessed the quality of the literature independently and identified the level of evidence. Results Fifteen pieces of literature were included, including 3 clinical decisions, 1 recommended practice, 1 evidence summary, 1 guideline, 8 systematic evaluations and 1 expert consensus. Twenty-two pieces of best evidence of 7 dimensions of management of UP patients were summarized, including assessment, dialysis management, medication management, local itch management, complementary and alternative therapy, life and psychological guidance. Conclusion This study summarizes and forms the management of patients with UP. Personalized management should be considered for patients with UP based on clinical practice and patients’ conditions and opinions during the clinical transformation of evidence, thus to further improve the quality of life of patients with UP.

Key words: uremia, end-stage renal disease, hemodialysis, peritoneal dialysis, skin pruritus, evidence-based nursing