How to care for patients with polymyositis

  Simple polymyositis is a diffuse non-suppurative inflammatory disease of the transverse muscle characterized by symmetrical weakness of the proximal muscles of the extremities, cervical muscles, pharyngeal muscles, muscle induration, and increased muscle enzyme profile. Its incidence is generally 0.5-8/100,000, if you can adhere to long-term treatment prognosis is good, if you can not adhere to regular treatment is easy to secondary muscle atrophy weakness or paralysis.  1, maintain a good mental state, learn to self-regulate, actively harmonize with the external environment, reduce tension and fear. Establish the confidence to adhere to long-term treatment. The patient’s family should care, considerate, understanding rheumatoid arthritis patient’s physical and mental pain, take the initiative to assist the patient’s life, more communication with them. Help patients face reality, self-motivation, self-motivation, self-improvement, eliminate dependence, and inspire them to family, children, social responsibility.  2, strengthen nutritional intake due to muscle fiber inflammation damage, repair requires a lot of protein, patients should choose high protein, high vitamin, low salt, easy to digest soft food, prohibit spicy and stimulating food, eat more food containing high potassium such as lean meat, soy products, cabbage, potatoes, etc.. For those who have difficulty in swallowing, they can eat liquid or semi-liquid, and take a sitting or semi-recumbent position when eating to prevent food from choking into the airway and causing aspiration pneumonia.  3, glucocorticosteroid adverse reactions observation and care glucocorticosteroid for the treatment of simple polymyositis drug of choice, during the use of drugs must strictly comply with the time of administration, dose, treatment process closely observe body temperature, stool color, blood routine, regular recheck electrolytes, prevent infection, hypokalemia, hypocalcemia, gastrointestinal bleeding and other complications.  4. Be prepared for long-term thinking about drug treatment, and do not rush into it. Adrenocorticotropic hormones and cytotoxic drugs are currently the main drugs used in the treatment of polymyositis, and long-term application can lead to many side effects. When there is hair loss, full moon face and other cosmetic changes, do not be depressed and worried, this is only a temporary side effect of the drug. If there is obvious discomfort, you should come to the hospital in time to see the doctor, do not stop the drug without authorization.  5, the patient’s activity depends on the severity of the disease, the acute period of absolute bed rest, avoid activities, so as not to aggravate the symptoms. To prevent muscle atrophy, patients should be encouraged to perform active or passive exercises in bed, such as flexing and extending the elbow and knee joints, lifting both arms and legs, etc.; further improvement of the condition can be supported by nurses or family members to walk, wash themselves, toileting, etc. Exercise should be carried out in a gradual manner, gradually increasing the intensity and time of exercise, but not strenuous exercise. For those who have muscle atrophy should be given massage or other physical therapy.  6, strengthen the awareness of self-care because glucocorticoids have immunosuppressive effect, long-term application of patients’ own resistance decreased, thus increasing the opportunity of infection. During the medication period, patients are advised to go to crowded public places as little as possible to prevent upper respiratory tract infection, maintain oral hygiene, prevent mold infection, keep skin clean and dry, and prevent skin breakage. Female patients pay attention to vulva cleanliness and prevent retrograde infection of the urinary system.  7, regular follow-up in order to observe the efficacy and drug response, change the drug or dose, patients need to come to the hospital for regular follow-up. In particular, patients should be instructed to avoid strenuous exercise before blood sampling for electromyography, which may affect the accuracy of test results. For electromyography, wear loose clothing and pants to expose the examined muscles, and pay attention to keeping warm when it is cold.