復健期燒傷病人搔癢之處置與照護

The Management of Itching in Burn Patients During the Rehabilitation Stage

燒傷後癒合皮膚搔癢是燒傷病人公認最困擾症狀之一。它不僅干擾病人日常生活、造成睡眠紊亂、引發焦慮及憂鬱等負向情緒，持續不當地抓搔，還會造成皮膚完整性受損、甚至影響植皮手術的成功。本文依序說明搔癢定義與機轉、如何透過搔癢評估找到誘發因素，藉由藥物治療、皮膚滋潤、按摩治療、矽膠使用以及放鬆訓練，同時輔以搔癢因應訓練，協助病人緩解此擾人不適的症狀。藉此讓臨床照護人員能對於本議題有更深廣的認識，應用於燒傷後癒合皮膚搔癢護理，進而提高病人生活品質。

Pruritus, a distressing symptom that affects burn patients, not only interferes with activities of daily living but also causes disturbed sleep, which has been associated with anxiety, depression, and other types of negative moods. Furthermore, the uncontrolled scratching that often accompanies pruritus causes tissue damage and may damage or destroy the skin graft. In this paper, the authors first describe the definition and mechanism of pruritus and next use itching-assessment tools to identify the triggering factors. Finally, the authors propose a multifaceted approach to treating pruritus that includes using medication, topical emollients, massage therapy, skin moisture, relaxation techniques, and combined coping to relieve patient discomfort. The authors hope that this paper deepens and broadens the knowledge of health professionals on this issue and improves the quality of care that is available for burn patients who are in the rehabilitation stage.