血液透析病人合併有不寧腿症候群之照護

Nursing Care of Hemodialysis Patients with Restless Legs Syndrome

10.6386/CGN.202212_33(4).0003

蔡麗紅(Li-Hung Tsai)；陳全美(Chuan-Mei Chen)

血液透析 ； 不寧腿症候群 ； 穴位按壓 ； 運動訓練 ； 按摩 ； hemodalysis ； restless legs syndrome ； acupressure ； exercise training ； massage

長庚護理

33卷4期（2022 / 12 / 01）

24 - 33

英文

不寧腿症候群（RLS）是一種神經和感覺運動障礙，續發性RLS與末期腎疾病（ESRD）有強烈相關。血液透析（HD）病人發生RLS的盛行率為19.4％～57.3％。RLS易導致HD病人不良的睡眠品質、憂鬱及低的生活品質，甚至可能增加共病症及死亡率。因此，緩解HD病人RLS之嚴重度是重要課題。本文就HD病人發生RLS之原因、診斷標準、藥物治療及非藥物治療（包括運動訓練、按摩、近紅外光療法、穴位按壓、震動治療）做介紹。提升臨床護理人員對於HD病人發生RLS的相關概念及照護進一步的認識，提供患者更優質的健康照護。

Restless legs syndrome (RLS) is a neurological and sensorimotor disorder,and secondary RLS is strongly associated with end-stage renal disease (ESRD). The prevalence of RLS in hemodialysis (HD) patients was 19.4% ~ 57.3%. The HD patients with RLS have been association poor sleep quality, depression, and lower quality of life, and even increase comorbidities and mortality. Therefore, alleviating the severity of RLS in HD patients is an important issue. This paper introduces the causes, diagnostic criteria, drug therapy and non-drug therapy (including exercise training, massage, near-infrared light therapy, acupressure, and vibration therapy) of HD patients with RLS to enhance the understanding of clinical nursing staff regarding RLS related concepts and nursing care for HD patients so they can provide excellent health care.

1. 莊玉華, Y. H.,戴秀珍, H. C.,許秀萍, H. P.,蔡麗紅, L. H.(2016)。照護一位血液透析病人合併不寧腿症候群之護理經驗。長庚護理，27(1)，132-143。
   連結：
2. Aliasgharpour, M.,Abbasi, Z.,Pedram Razi, S.,Kazemnezhad, A.(2016).The effect of stretching exercises on severity of restless legs syndrome in patients on hemodialysis.Asian Journal of Sports Medicine,7(2),e31001-e31001.
3. Allen, R. P.,Picchietti, D. L.,Garcia-Borreguero, D.,Ondo, W. G.,Walters, A. S.,Winkelman, J. W.,Zucconi, M.,Ferri, R.,Trenkwalder, C.,Lee, H. B.(2014).Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance.Sleep Medicine,15(8),860-873.
4. Bathla, N.,Ahmad, S.,Gupta, R.,Ahmad, S.(2016).Prevalence and correlates of Willis Ekbom's disease/restless legs syndrome in patients undergoing hemodialysis.Saudi Journal Of Kidney Diseases And Transplantation: An Official Publication Of The Saudi Center For Organ Transplantation, Saudi Arabia,27(4),685-691.
5. Bega, D.,Malkani, R.(2016).Alternative treatment of restless legs syndrome: an overview of the evidence for mind-body interventions, lifestyle interventions, and neutraceuticals.Sleep Medicine,17(1),99-105.
6. de Menezes, A. F.,Motta, D. R. M. d. S.,de Carvalho, F. O.,Santana-Santos, E.,de Andrade Júnior, M. P.,Figueirôa, M. F.,Farias, M. I. T.,Bastos, K. d. A.(2018).Restless legs syndrome in dialysis patients: does the dialysis modality influence its occurrence and severity?.International Journal Of Nephrology,2018,1414568-1414568.
7. Giannaki, C. D.,Hadjigavriel, M.,Lazarou, A.,Michael, A.,Damianou, L.,Atmatzidis, E.,Stefanidis, I.,Hadjigeorgiou, G. M.,Sakkas, G. K.,Pantzaris, M.(2017).Restless legs syndrome is contributing to fatigue and low quality of life levels in hemodialysis patients.World Journal Of Nephrology,6(5),236-242.
8. Giannaki, C. D.,Hadjigeorgiou, G. M.,Karatzaferi, C.,Maridaki, M. D.,Koutedakis, Y.,Founta, P.,Tsianas, N.,Stefanidis, I.,Sakkas, G. K.(2013).A single-blind randomized controlled trial to evaluate the effect of 6 months of progressive aerobic exercise training in patients with uraemic restless legs syndrome.Nephrology, Dialysis, Transplantation,28(11),2834-2840.
9. Guay, A.,Houle, M.,O'Shaughnessy, J.,Descarreaux, M.(2020).Current evidence on diagnostic criteria, relevant outcome measures, and efficacy of nonpharmacologic therapy in the management of restless legs syndrome (RLS): a scoping review.Journal of Manipulative and Physiological Therapeutics,43(9),930-941.
10. Hashemi, S. H.,Hajbagheri, A.,Aghajani, M.(2015).The effect of massage with lavender oil on restless leg syndrome in hemodialysis patients: a randomized controlled trial.Nursing And Midwifery Studies,4(4),e29617-e29617.
11. Hosseini, H.,Kazemi, M.,Azimpour, S.(2016).The effect of vibration on the severity of restless legs syndrome in hemodialysis patients.Journal Of Renal Injury Prevention,6(2),113-116.
12. Klingelhoefer, L.,Bhattacharya, K.,Reichmann, H.(2016).Restless legs syndrome.Clinical Medicine,16(4),379-382.
13. Kutlu, R.,Selcuk, N. Y.,Sayin, S.,Kal, O.(2018).Restless legs syndrome and quality of life in chronic hemodialysis patients.Nigerian Journal Of Clinical Practice,21(5),573-577.
14. Lin, C. H.,Wu, V. C.,Li, W. Y.,Sy, H. N.,Wu, S. L.,Chang, C. C.,Chiu, P. F.,Lion, H. H.,Lin, C. Y.,Chang, H. W.,Lin, S. Y.,Wu, K. D.,Chen, Y. M.,Wu, R. M.(2013).Restless legs syndrome in end-stage renal disease: a multicenter study in Taiwan.European Journal Of Neurology,20(7),1025-1031.
15. Lin, X. W.,Zhang, J. F.,Qiu, M. Y.,Ni, L. Y.,Yu, H. L.,Kuo, S. H.,Ondo, W. G.,Yu, Q.,Wu, Y. C.(2019).Restless legs syndrome in end stage renal disease patients undergoing hemodialysis.BMC Neurology,19(1),47-47.
16. Mitchell, U. H.(2011).Nondrug-related aspect of treating Ekbom disease, formerly known as restless legs syndrome.Neuropsychiatric Disease and Treatment,7,251-257.
17. Mohammadi, M. M.,Raygani, A. A. V.,Ghobadi, A.,Samadzadeh, S.,Salari, N.(2018).Effect of near-infrared light therapy based on acupoints on the severity of restless legs syndrome in patients undergoing hemodialysis: a singleblind randomized controlled trial.Clinical Medicine & Research,16(1-2),1-8.
18. Mortazavi, M.,Vahdatpour, B.,Ghasempour, A.,Taheri, D.,Shahidi, S.,Moeinzadeh, F.,Dolatkhah, B.,Dolatkhah, S.(2013).Aerobic exercise improves signs of restless leg syndrome in end stage renal disease patients suffering chronic hemodialysis.The Scientific World Journal,2013,628142-628142.
19. Nasiri, M.,Abbasi, M.,Khosroabadi, Z. Y.,Saghafi, H.,Hamzeei, F.,Amiri, M. H.,Yusefi, H.(2019).Short-term effects of massage with olive oil on the severity of uremic restless legs syndrome: a double-blind placebo-controlled trial.Complementary Therapies In Medicine,44,261-268.
20. Örsal, Ö.,Ünsal, A.,Balcı-Alparslan, G.,Duru, P.(2017).Restless legs syndrome and sleep quality in patients on hemodialysis. nephrology nursing journal: journal of the american nephrology nurses' association.Neuropsychiatric Disease and Treatment,44(2),167-176.
21. Salib, M.,Memon, A. N.,Gowda, A. S.,Rallabhandi, B.,Bidika, E.,Fayyaz, H.,Cancarevic, I.(2020).Dialysis patients with restless leg syndrome: can we relieve their suffering?.Cureus,12(8),e10053.
22. Shahgholian, N.,Jazi, S. K.,Karimian, J.,Valiani, M.(2016).The effects of two methods of reflexology and stretching exercises on the severity of restless leg syndrome among hemodialysis patients.Iranian Journal Of Nursing And Midwifery Research,21(3),219-224.
23. Song, H. J.,Seo, H. J.,Lee, H.,Son, H.,Choi, S. M.,Lee, S.(2015).Effect of self-acupressure for symptom management: a systematic review.Complementary TherapiesIn Medicine,23(1),68-78.
24. Tsai, L. H.,Chen, C. M.,Lin, L. M.,Tsai, C. C.,Han, Y.,See, L. C.(2022).Acupressure reduces the severity of restless legs syndrome in hemodialysis patients: A cluster-randomized crossover pilot study.Biomed Journal,45(3),533-541.
25. Tsai, L. H.,See, L.C.,Chien, C. C.,Chen, C. M.,Chang, S. H.(2019).Risk factors for restless legs syndrome in hemodialysis patients in Taiwan: a case-control study.Medicine,98(51),e18450-e18450.
26. Turk, A. C.,Ozkurt, S.,Turgal, E.,Sahin, F.(2018).The association between the prevalence of restless leg syndrome, fatigue, and sleep quality in patients undergoing hemodialysis.Saudi Medical Journal,39(8),792-798.
27. Ul Abideen, Z.,Mahmud, S. N.,Mushtaq, F.,Farooq, M. U.,Farooq Qasim, Y.,Hamid, Z.,Rasheed, A.,Zafran, M.,Nabeel Pasha, M.,Pirzada, F.(2018).Association of hemodialysis inadequacy and duration with restless legs syndrome: a cross-sectional study.Cureus,10(5),e2570-e2570.
28. Walters, A. S.,LeBrocq, C.,Dhar, A.,Hening, W.,Rosen, R.,Allen, R. P.,Trenkwalder, C.(2003).Validation of the international restless legs syndrome study group rating scale for restless legs syndrome.Medicine,4(2),121-132.
29. Zhang, L. Y.,Ma, X. Y.,Lin, J.,Liu, W. H.,Guo, W.,Yin, L.,Wang, S. X.,Li, X.,Li, J.,Jin, L. L.,Tian, Z. L.,Du, Y. T.,Tuo, H. Z.(2020).Prevalence and risk factors of restless legs syndrome in hemodialysis patients.Nature and Science of Sleep,12,19-27.
30. 陳彥融, Y. L.,林士為, S. W.,莊立邦, L. P.,賴思佳, S. C.,陳柔賢, R. S.,陳濘宏, N. H.(2013)。中文版國際不寧腿症候群量表之效度分析。胸腔醫學，28(2)，65-72。