Muscle spasm is one of the most common complications of hemodialysis, accounting for about 20% of dialysis patients. Especially prone to dehydration in dialysis patients and elderly patients. Especially in the middle and late stages of dialysis, patients often suffer from pain, dialysis can not adhere to the inadequate dialysis, not dry weight, triggering some of the more serious complications.
Clinical manifestations of intramuscular tonic muscle contraction within a few hours of dialysis. Manifested as lower extremity muscle or abdominal muscle spasm, severe pain, and more common in the gastrocnemius, foot muscles, abdominal muscles and so on. Patients are often accompanied by mental stress, heart rate, severe cold accompanied by sweat, and even blood pressure, the duration of a few minutes, often requiring urgent treatment.
The main causes of muscle spasms are: hypotension during dialysis; patient weight below body weight after ultrafiltration, persisting spasms during late dialysis and persistence up to hours after dialysis; hyponatremia Decline can make the blood vessels in the muscle contraction, muscle ischemia caused by spasms. Dialysis process to avoid the above risk factors in order to reduce the occurrence of muscle spasm.
Prevention of hypotension, strict control of dialysis interval of water intake, reduce dehydration. Prevention of hypotension can prevent the occurrence of most spasms, and some patients may avoid spasm by increasing dialysate sodium concentration during the last 1-2 hours of dialysis.
Set dry weight correctly, dry weight changes with time and nutritional status. For patients with hypotension and muscle spasm after dialysis, dry weight should be adjusted in time. In addition, the increase or loss of clothing should also be included in the evaluation of dry weight. Patients are advised to weigh each change of clothing and report to their doctor.
Psychological care, there are many patients with muscle spasm because of the pain experienced spasm, mental stress in dialysis, prone to spasm. You can take the conversation with the patient and other ways to make the patient relaxed, eliminating the patient's fear, anxiety.
Health education to guide patients with a scientific and rational diet, appropriate to increase the intake of high-quality protein, vitamins, dialysis intravenous supplementation of levarnitine, to correct hypocalcemia to reduce the occurrence of muscle spasm.
The acute myospasm can be treated with hyperosmotic sugar or saline , and because the sodium load of the hyperosmotic saline can cause thirst after dialysis , it is better to treat muscle spasm with hyperosmotic sugar for non - diabetic patients .
Dialysis in the occurrence of muscle spasms dialysis patients with a lot of pain, easy to make patients pessimistic disappointment, loss of confidence in the continued treatment. Therefore, our patients to strengthen understanding of dialysis, prevention in advance, scientific diet, weight control, minimize the occurrence of muscle spasms.