袋鼠式护理模式对新生儿肌肉注射疫苗疼痛护理的影响

[目的]探讨袋鼠式护理模式应用于肌肉注射疫苗新生儿对疼痛的影响。[方法]将进行肌肉注射疫苗的新生儿98例随机分为观察组与对照组,每组49例。对照组新生儿接受肌肉注射时采取常规护理,观察组新生儿采取袋鼠式护理,记录两组新生儿疼痛评估量表(NIPS)评分、心率和血氧饱和度等数据,并进行对比分析。[结果]观察组新生儿NIPS总分低于对照组(P0.05);注射时与注射后观察组新生儿心率均低于对照组新生儿,血氧饱和度均高于对照组新生儿,经比较差异有计学意义(P0.05)。[结论]袋鼠式护理模式应用于肌肉注射疫苗的新生儿,可通过缓解新生儿疼痛而降低对心率和血氧饱和度的刺激,同时还能促进母婴情感交流,并且减轻护理人员注射时新生儿啼哭导致的紧迫感。     

乙肝疫苗联合乙肝免疫球蛋白阻断乙肝病毒传播的临床应用评价

目的对乙肝疫苗联合乙肝免疫球蛋白(HBIG)阻断乙肝病毒(HBV)在母婴间传播的临床效果进行研究,分析和探讨阻断乙肝病毒传播的方法。方法选取本院2012年3月至2013年11月收治的120例乙肝病毒表面抗原(HBsAg)阳性孕妇,将之随机均分为对照组和试验组。对照组60例HBsAg阳性孕妇产前不予药物注射,新生儿出生后12h内,肌肉注射HBIG 200IU和乙肝疫苗10μg,1、6月龄接受常规的乙肝疫苗注射,每次注射10μg;试验组对60例HBsAg阳性孕妇于妊娠28、32和36周肌肉注射HBIG 200IU,共3次,在新生儿出生后12h内,分别注射HBIG 100IU及乙肝疫苗10μg,1月,6月龄接受常规的乙肝疫苗注射,每次注射10μg。所有婴儿在周岁时采血,乙肝标志物检测使用酶联免疫吸附法,HBV-DNA病毒载量采用PCR荧光定量方法,对结果进行分析。结果对照组60例孕妇中,新生儿HBV宫内感染14例,感染率为23.33%;试验组60例孕妇中,新生儿HBV宫内感染5例,感染率为8.33%(χ2=5.07,P0.05),新生儿出生一年后,对照组HBV感染10例,阻断率为83.33%;试验组感染1例,阻断率为98.33%(χ2=8.10,P0.05),两者差异具有统计学意义。对照组60例孕妇中,新生儿HBsAb阳性为5例,阳性率为8.33%;试验组60例孕妇中,新生儿HBsAb阳性为17例,阳性率为28.33%(χ2=8.02,P0.05)。新生儿出生一年后,对照组HBsAb阳性47例,阳性率为78.33%,试验组60例孕妇中,新生儿HBsAb阳性为56例,阳性率为93.33%(χ2=5.55,P0.05),两者差异具有统计学意义。结论使用乙肝疫苗联合HBIG可显著降低HBsAg阳性妇女所产婴儿乙肝病毒的感染率,有效提高婴儿HBsAb的应答率,从而有效地阻断了乙肝病毒的传播,保护了婴儿的健康,具有临床推广的价值。     

新生儿铁储备对6月龄婴儿神经发育的影响

目的 探讨新生儿铁储备对6月龄婴儿神经发育的影响。方法 连续性收集2016年11月至2018年1月出生的新生儿及其父母129对。用酶联免疫吸附法测定脐血铁蛋白、C反应蛋白、α1酸性糖蛋白。根据脐血铁蛋白浓度将婴儿分为铁蛋白充足、不足和缺乏3组。采用标准问卷收集研究对象的基本资料，采用Gesell发育诊断量表在婴儿6月龄时行发育评估。比较不同脐血铁蛋白水平婴儿6月龄时在神经发育上的差异。结果 新生儿脐血铁蛋白平均浓度为（75.3±45.0）μg/L，其中铁蛋白缺乏22例（17.1%），铁蛋白不足54例（41.9%）。脐血铁蛋白充足、不足和缺乏3组婴儿6月龄时在适应性及大动作行为评分达标率的差异有统计学意义（P <0.05）。铁蛋白充足组与缺乏组在适应性和大动作行为评分达标率的差异有统计学意义（P <0.05）。结论 铁蛋白不足和缺乏在新生儿中普遍存在，脐血铁蛋白充足的新生儿6月龄时在适应性及大动作行为评分的达标率比脐血铁蛋白缺乏的更高，孕期铁营养及新生儿铁储备状况值得进一步关注。     

预警风险制度对新生儿肺炎症状改善及家长满意度的影响

目的:探讨预警风险制度对新生儿肺炎症状改善及家长满意度的影响。方法:选择2020年1月1日～3月31日进行治疗的肺炎新生儿100例作为对照组,采取常规护理模式;选择2020年4月1日～6月30日进行治疗的肺炎新生儿100例作为观察组,采取预警风险制度管理。比较两组肺炎症状改善时间、住院时间、舒适度、护理前后情绪状态[采用新生儿疼痛评分(NIPS)和新生儿精神行为评估量表(NBNA)]、不良事件发生情况、家长护理满意度。结果:观察组喘息、咳嗽、发热、肺部湿啰音改善时间和住院时间均短于对照组(P0.01,P0.05);观察组心理舒适和生理舒适评分均优于对照组(P0.05,P0.01);护理后,两组NIPS评分低于护理前(P0.05),NBNA评分高于护理前(P0.05),且观察组NBNA评分高于对照组(P0.05);观察组窒息、中毒性脑病、心力衰竭等不良事件发生率低于对照组(P0.05);观察组家长在人文关怀、健康教育、护理操作和院内管理4个方面的护理满意度得分高于对照组(P0.01,P0.05)。结论:预警风险制度有利于加快新生儿肺炎症状的恢复时间、缩短住院时间,帮助新生儿提高生理、心理舒适程度,减少不良事件发生,家长对护理的满意度更高。     

不同来源乙肝疫苗乙肝基因工程疫苗阻断HBV母婴传播的临床研究

对HBsAg伴HBeAg阳性(简称双阳)的母亲所产婴儿170例,采用不同来源的乙肝疫苗、乙肝基因工程疫苗,阻断乙肝母婴传播,其中142例注射基因疫苗,28例注射血源性乙肝疫苗,结果表明,两者效果相近.而0月龄注射基因疫苗10μg+HBIG100IU,1月和6月龄注射基因疫苗10μg效果最佳,抗HBS阳转率97.7%,保护率为100%,高于其它基因疫苗组,经过X~2检验,P<0.05,差异有显著性.血源性乙肝疫苗组,以0月和2月龄注射HBIG、3月和5月龄注射乙肝疫苗20μg组效果最佳,抗HBS阳转率90.9%.保护率为100%,HBIG对中和婴幼儿体内的乙肝病毒起着重要作用.     

早期干预对呼吸衰竭早产儿脑损伤的疗效评价

目的探讨早期康复干预治疗对呼吸衰竭早产儿脑损伤预后的影响。方法选取本院新生儿重症监护室(NICU)生后24 h内入院即诊断为呼吸衰竭(NRF)的早产儿共151例,均行气管插管机械通气,且并发早产儿脑损伤。按入院时间和家长意愿分为常规组(n=71)和干预组(n=80)。两组患儿均接受常规保健指导;干预组住院病情稳定后接受抚触、被动操及听、视、触觉刺激。并于出院后给予干预组主动运动训练及家庭干预。两组患儿均在纠正年龄40周行NBNA评分,3、6月龄时采用婴儿神经系统国际测验量表(Infanib)进行早期运动发育评估,6、12、18个月时采用中国科学院心理研究所和中国儿童发展中心(CDCC)婴幼儿智能发育量表对其进行智力指数测定,18个月时采用Gesell发育诊断量表评分。结果两组40周时NBNA评分无显著性差异(P0.05)。呼吸衰竭早产儿于3月龄、6月龄时进行Infanib评估,干预组正常的比例均高于常规组(P0.05)。干预组生后6、12、18个月时CDCC的智力发育指数(MDI)和心理运动发育指数(PDI)得分均显著高于常规组(P0.001)。18月龄时,干预组Gesell发育诊断量表的大运动、精细动作,以及适应性、语言、社会交往能力得分都显著高于常规组(P0.001)。干预组后遗症的发生率为12.5%,低于常规组的25.4%(P0.05)。结论早期康复干预对智力和运动发育起促进作用,可改善呼吸衰竭早产儿脑损伤的预后。     

“三对一”导乐陪伴分娩对产妇产程及新生儿的影响

目的探讨＂三对一＂导乐式陪伴分娩对产妇分娩方式、产程、产后出血及新生儿的影响。方法临产前随机抽取2010年9月至2011年3月施行导乐式分娩的初产妇45例做为导乐组,实施＂三对一＂导乐的助产士、医师和家属在产前、产时、产后2 h全程陪伴;另外抽取2010年1月至2010年8月,由当班助产士陪伴无专人连续陪伴分娩的初产妇54例做为对照组,实施常规三班轮换的护理模式观察产程。观察两组产妇剖宫产率、新生儿窒息率、新生儿出生1 min Apgar评分、产妇满意度、产程时间、产时及产后2 h出血量及宫缩疼痛评分。结果导乐组的剖宫产率、新生儿窒息率显著低于对照组（χ2=4.10984,.1611,P均〈0.05）;导乐组的新生儿出生1 min Apgar评分、产妇满意度显著高于对照组（t=2.5459,χ2=7.3569,P均〈0.05）;导乐组第一、二产程和总产程时间均短于对照组（t=2.0644,2.1392,2.0741,P均〈0.05）;导乐组产时及产后2 h出血量及宫缩疼痛评分均显著少于对照组（t=2.0997,2.4915,P均〈0.05）。结论导乐式分娩能减轻产妇紧张焦虑情绪和宫缩疼痛,有效缩短产程,减少产后出血,提高新生儿出生1 min Apgar评分和产妇满意度,有效减少剖宫产率和新生儿窒息率。     

亲子陪护模式对改善新生儿病房住院患儿疾病转归的影响

目的:探讨亲子陪护模式对改善新生儿病房住院患儿疾病转归的效果。方法:选取2016年1月～2018年5月新生儿病房收治的204例患儿为研究对象,根据陪护区护理组长及新生儿专科医生评估结果,结合家长意愿分为无陪护组(n=136)及亲子陪护组(n=68)。无陪护组患儿给予无陪区常规护理干预,亲子陪护组患儿采取亲子陪护模式护理干预,比较两组患儿总住院费用、住院时间及家长满意度。结果:亲子陪护组黄疸、肺炎患儿住院时间及奶粉费用均低于无陪护组(P 0. 05),但总住院费用高于无陪护组(P 0. 05);亲子陪护组患儿家长护理满意度高于无陪护组(P 0. 05)。结论:虽然新生儿病房住院患儿采用亲子陪护模式总住院费用增加,但是促进了疾病转归,缩短了患儿的住院时间,提高了患儿家长满意度,有利于构建和谐护患关系,值得临床重视。     

探讨分析PDCA循环管理模式在改善新生儿红臀中的应用效果

目的:研究PDCA循环管理模式在改善新生儿红臀中的临床效果。方法:选择2018年1月至2018年12月入住本院新生儿科中的597例进行研究,从2018年7月开始开展PDCA循环管理模式,将接受PDCA循环管理模式管理后的305例新生儿视作观察组,将未接受PDCA循环管理模式管理的292例新生儿视作对照组,比较两组新生儿红臀发生情况。结果:观察组红臀发生率为8.85%,低于对照组发生率15.75%(χ^2=6.6195,P=0.0101);观察组新生儿红臀愈合时间为(3.04±0.24)d,短于对照组(4.52±0.39)d,(t=55.5526,P=0.0000);观察组家长对护理管理的满意度为95.08%,高于对照组家长的满意度81.85%(χ^2=25.8813,P<0.0000)。结论:PDCA循环管理模式的应用能够明显降低新生儿红臀发生率,加快红臀愈合,提升家长满意度。     

新生儿监护病房患儿操作性疼痛发生现状研究

目的调查监护病房新生儿住院期间经历的操作性疼痛情况,为临床疼痛管理提供参考。方法选取新生儿监护病房患儿70例为研究对象,采用床旁观察的方法,记录住院期间因诊断、护理、治疗需要而接受的致痛性操作。结果 70例患儿经历致痛性操作中位数为12.5(6.75,30.25)次/人,4(2,7)次/人/d。最常见的致痛性操作是足跟采血(27.09%),不同胎龄患儿疼痛程度不同(P0.05)。结论新生儿监护病房患儿住院期间经历了大量的疼痛刺激,早产儿接受的致痛性操作频次高于足月儿,重视和规范我国新生儿疼痛管理势在必行。     

Differences in pain expression between male and female newborn infants

The study of neonatal gender differences in pain expression is important since neonatal pain behavior occurs prior to any learned reaction pattern. The objective of this study was to verify the presence of gender differences in pain expression in preterm and term newborn infants. Sixty-five consecutive neonates (37 female and 28 male infants) with gestational age between 28 and 42 weeks and with 25-120 h of life were studied. Healthy term neonates required a capillary puncture for PKU screening and clinically stable premature infants needed a capillary puncture for glucose dosage. The Neonatal Facial Coding System (NFCS) and the Neonatal Infant Pain Scale (NIPS) were evaluated at bedside prior to the puncture, when patients were at rest, during foot heating; during capillary puncture; and at 1, 3, and 5 min after heel lancing. Results were analyzed by repeated-measures ANOVA followed by the Multiple Comparison Method of Bonferroni. A significant difference among the mean NFCS scores during the six study periods was noted for the whole group of neonates (P<0.000001). Also, a significant interaction between the NFCS score profile in female and male neonates at the different study periods was observed (P=0.025). Regarding NIPS, ANOVA showed only a significant difference among the mean NIPS scores during the six study periods for the whole group of neonates (P<0.000001). No significant interactions between gestational age and time, nor between gestational age and gender were noted, for both NFCS and NIPS. In conclusion, recently born female neonates of all gestational ages expressed more facial features of pain than male infants, during the capillary puncture and 1 min afterwards. Maybe differences in pain processing and/or pain expression among genders may explain this finding.     

非营养性吸吮和吸吮8%葡萄糖水对缓解新生儿疼痛的效果观察

目的探索非药物治疗缓解新生儿疼痛的有效方法。方法将130例住院新生儿随机分为非营养性吸吮组和吸吮8%葡萄糖水组,各65例,在采足跟血疼痛刺激前30s、穿刺后20s、1min、3min分别记录心率、呼吸、经皮血氧饱和度和哭声持续时间,并在穿刺1min后根据新生儿面部编码系统、新生儿疼痛评估量表进行疼痛评分。结果穿刺后20s两组新生儿心率加快(P0.01),1min时恢复到穿刺前水平;穿刺后20s、1min两组新生儿呼吸频率均加快(P0.05),3min时恢复到穿刺前水平;两组新生儿穿刺前后经皮血氧饱和度均无明显变化(P0.05);穿刺后吸吮8%葡萄糖水组新生儿哭声持续时间少于非营养性吸吮组(P0.01);吸吮8%葡萄糖水组新生儿面部编码系统和新生儿疼痛评估量表评分均低于非营养性吸吮组(P0.05或P0.01)。结论新生儿对急性疼痛很敏感,吸吮8%葡萄糖水对新生儿有相对较好的止痛作用,在临床护理中,可应用非药物治疗干预措施。     

Initial validation of the Behavioral Indicators of Infant Pain (BIIP)

Accurate pain assessment in preterm infants in the neonatal intensive care unit (NICU) is complex. Infants who are born at early gestational ages (GA), and who have had greater early pain exposure, have dampened facial responses which may lead to under-treatment. Since behavioral and physiological responses to pain in infants are often dissociated, using multidimensional scales which combine these indicators into a single score may limit our ability to determine the effects of interventions on each system. Our aim was to design a unidimensional scale which would combine the relatively most specific, individual, behavioral indicators for assessing acute pain in this population. The Behavioral Indicators of Infant Pain (BIIP) combines sleep/wake states, 5 facial actions and 2 hand actions. Ninety-two infants born between 23 and 32 weeks GA were assessed during 3, 1 min Phases of blood collection. Outcome measures included changes in BIIP and in Neonatal Infant Pain Scale (NIPS) scores coded in real time from continuous bedside video recordings; changes in heart rate (HR) were obtained using custom physiological processing software. Scores on the BIIP changed significantly across Phases of blood collection (p<0.01). Internal consistency (0.82) and inter-rater reliability (0.80-0.92) were high. Correlations between the BIIP and NIPS were modest (r=0.64, p<0.01) as were correlations between the BIIP and mean heart rate (r=0.45, p<0.01). In this initial study, the BIIP has been shown to be a reliable, valid scale for assessing acute pain in preterm infants in the NICU.     

非营养性吸吮联合拥抱抚触对缓解新生儿疼痛的效果观察

目的:探讨非药物治疗措施缓解新生儿疼痛的效果。方法:将80例住院新生儿随机分为非营养性吸吮组(对照组)和非营养性吸吮联合拥抱抚触组(观察组)各40例,在采足跟血疼痛刺激前,刺激后20 s、1 min、3 min分别记录心率、呼吸、经皮氧饱和度和哭声持续时间,并在穿刺1 min后根据新生儿面部编码系统、新生儿疼痛评估量表进行疼痛评分。结果:穿刺后20 s两组新生儿心率加快(P<0.05),1 min时心率恢复到穿刺前水平;穿刺后20 s、1 min两组新生儿呼吸频率均加快(P<0.05),3 min时恢复到穿刺前水平;两组新生儿穿刺前后经皮血氧饱和度均无明显变化(P>0.05),穿刺后非营养性吸吮联合拥抱抚触组新生儿哭声持续时间少于非营养性吸吮组(P<0.05);且新生儿面部编码系统和新生儿疼痛评估量表评分均低于非营养性吸吮组(P<0.05)。结论:新生儿对急性疼痛很敏感,非药物治疗干预措施有较好的止痛作用,综合两种非药物治疗措施缓解新生儿疼痛效果更明显。     

宫外生长发育迟缓早产儿1岁内生长发育迟缓发生情况及其影响因素

目的分析宫外生长发育迟缓（EUGR）早产儿出院后校正年龄1岁内生长发育迟缓发生情况及其影响因素。 方法选取2014年7月至2017年12月在泰安市中心医院新生儿重症监护治疗病房（NICU）住院治疗且正常出院的90例EUGR早产儿。对90例EUGR早产儿在校正年龄1岁内进行定期随访，测量体质量、身长、头围等，并收集相关临床资料，如喂养情况、疾病情况、前白蛋白量、元素锌含量等，分析出院后EUGR早产儿校正年龄1岁内生长发育迟缓发生情况及其影响因素。采用t检验比较生长发育迟缓患儿和非生长发育迟缓患儿母亲年龄、出生体质量、出院体质量、胎龄、住院时间、达完全肠内营养时间、血前白蛋白、血锌等指标的差异。采用χ²检验比较生长发育迟缓患儿和非生长发育迟缓患儿双胎、妊娠高血压综合征、糖尿病、胎膜早破、宫内生长发育迟缓（IUGR）、窒息、剖宫产、新生儿呼吸窘迫综合征（NRDS）、支气管肺发育不良（BPD）、新生儿坏死性小肠结肠炎（NEC）、应用有创呼吸机、贫血、感染等的发生情况以及不同喂养方式的差异。对生长发育迟缓的高危因素进行logistic回归分析。 结果对EUGR早产儿随访时间点为校正年龄1个月、6个月、12个月，分别为90例、86例、70例，生长发育迟缓发生率分别为48.9%（44/90）、30.2%（26/86）、17.1%（12/70）。在校正年龄1个月时，与非生长发育迟缓患儿相比较，生长发育迟缓患儿IUGR、NRDS、BPD、应用有创呼吸机的发生率明显增高，差异有统计学意义（χ²=10.146，P=0.001；χ²=7.479，P=0.006；χ²=14.407，P<0.001；χ²=10.500，P=0.001）；出生体质量、出院体质量、胎龄、血前白蛋白明显降低，差异有统计学意义（t=-4.945，P<0.001；t=-3.522，P=0.001；t=-2.047，P=0.044；t=-2.312，P=0.023）；住院时间、达完全肠内营养时间明显延长，差异有统计学意义（t=3.797，P<0.001；t=2.840，P=0.006）；在喂养方式方面明显不同，差异有统计学意义（χ²=7.060，P=0.029）。logistic回归分析表明，生长发育迟缓与达完全肠内营养时间（P=0.040）、IUGR（P<0.001）及BPD（P=0.011）有显著相关性。在校正年龄6个月时，与非生长发育迟缓患儿相比较，生长发育迟缓患儿IUGR、NRDS、BPD、应用有创呼吸机的发生率明显增高，差异有统计学意义（χ²=8.474，P=0.004；χ²=12.613，P<0.001；χ²=24.398，P<0.001；χ²=12.662，P<0.001）；出生体质量、出院体质量、胎龄、血前白蛋白明显降低，差异有统计学意义（t=-5.849，P<0.001；t=-3.211，P=0.002；t=-3.405，P=0.001；t=-2.636，P=0.010）；住院时间、达完全肠内营养时间明显延长，差异有统计学意义（t=5.351，P<0.001；t=3.095，P=0.003）。logistic回归分析表明，生长发育迟缓与出生体质量（P=0.013）、IUGR（P=0.001）及BPD（P=0.022）有显著相关性。在校正年龄12个月时，与非生长发育迟缓患儿相比较，生长发育迟缓患儿IUGR、NRDS、BPD的发生率明显增高，差异有统计学意义（χ²=4.050，P=0.044；χ²=5.737，P=0.017；χ²=8.393，P=0.004）；出生体质量、胎龄、前白蛋白明显降低，差异有统计学意义（t=-3.192，P=0.002；t=-2.271，P=0.026；t=-3.509，P=0.001）；住院时间明显延长，差异有统计学意义（t=3.133，P=0.003）。logistic回归分析表明，生长发育迟缓与IUGR（P=0.040）及BPD（P=0.003）有显著相关性。 结论NICU出院的EUGR早产儿是一组特殊的高危人群，IUGR、BPD是出院后发生生长迟缓的持续危险因素。     

The effects of auditory interventions on pain and comfort in premature newborns in the neonatal intensive care unit; a randomised controlled trial

ObjectiveThis study investigated the effects of three auditory interventions; white noise, recorded mother's voice, and MiniMuffs, applied during a heel lance on pain and comfort in premature infants in the neonatal intensive care units.Design and methodsThis experimental, parallel, randomised controlled research was conducted in a state hospital tertiary-level neonatal intensive care unit. The sample comprised sixty-four premature infants with gestational ages of 31–36 weeks. The infants were randomly assigned to four groups: i) white noise, ii) recorded mother’s voice, iii) MiniMuffs, and iv) control. Pain and comfort of newborns were evaluated according to the Neonatal Infant Pain Scale (NIPS) and the COMFORTneo scale. Oxygen saturation, heart rate, and crying time were also measured.ResultsThe mean of oxygen saturation levels in the white noise, recorded mother's voice, and MiniMuffs group were higher than the control group. The heart rate, crying time, mean NIPS score, COMFORTneo score of the premature neonates in the white noise, recorded mother’s voice, and MiniMuffs groups were significantly lower than the control group (p < .001).ConclusionAuditory interventions used during heel lance reduce the pain and increase the comfort of the premature infants. White noise is extremely effective in preventing infants’s pain.     

Judgments of pain in the neonatal intensive care setting: a survey of direct care staffs' perceptions of pain in infants at risk for neurological impairment

OBJECTIVE: To determine whether healthcare professionals believe the pain of infants at risk for neurologic impairment differs from that of typical infants. SETTING: Neonatal intensive care units at 2 tertiary pediatric centers in Canada. PARTICIPANTS: Ninety-nine healthcare professionals who practice in the neonatal intensive care unit (51 nurses, 19 physicians, 18 respiratory therapists, 11 other). MAJOR MEASURES: Participants completed the Pain Opinion Questionnaire. It elicits beliefs regarding the similarity of the pain experienced by infants at mild, moderate, and severe risk for neurologic impairment relative to those without risk for neurologic impairment along 5 pain facets (ie, sensation, emotional reaction, behavioral reaction, communication, incidence). RESULTS: Pain Opinion Questionnaire scores varied by level of risk of neurologic impairment (mild, moderate, severe) and pain facet. Respondents believed infants with risk were overall less likely to experience pain similar to infants without risk as the level of risk increased [F(2,97) = 66.0, P < 0.001] and were more likely to have a reduced pain experience relative to infants without risk as the level of risk increased [F(2,97) = 62.2, P < 0.001]. Pain Opinion Questionnaire scores did not vary due to profession, experience, gender, or age. CONCLUSION: Professionals expressed the belief that neurologically impaired infants' pain experience is reduced, relative to infants without impairment, as their level of risk for neurologic impairment increases. This belief did not vary due to professional experience or personal factors. Future studies should investigate the source of these beliefs and their impact on the pain management provided to infants with risk for neurologic impairment.     

以家庭为中心的护理在重症监护室支气管肺发育不良早产儿中的应用效果

目的 研究以家庭为中心的护理在重症监护室支气管肺发育不良早产儿中的应用效果。 方法 选取2016年2月-2018年2月我院新生儿重症监护室收治的90例支气管肺发育不良早产儿为观察对象。通过随机抽签法将其分成实验组和对照组。对照组采用常规护理,实验组则采用以家庭为中心的护理。比较干预后2组患儿,出院时奶量以及体质量增至正常的人数占比,用氧时间与住院时间,并采用焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS)评估2组患儿父母心理状况。 结果 出院时,实验组患儿奶量及体质量增至正常的人数多于对照组(χ²=4.939,P=0.026;χ²=5.075,P=0.024)。用氧时间、住院时间短于对照组(t=5.650,P<0.001; t=8.167,P<0.001)。实验组患儿父母SAS、SDS评分均低于对照组(t=5.409,P<0.001; t=7.017,P＜0.001)。 结论 以家庭为中心的护理应用于支气管肺发育不良早产儿中效果显著,有利于促进患儿早日康复,缩短用氧时间以及住院时间,同时有利于改善患儿父母的焦虑、抑郁等不良情绪。     

Effect of breast-feeding on pain relief during infant immunization injections

Using a quasi-experimental design, this study was conducted in two maternal & child health centres in Jordan to examine the effects of breast-feeding on pain relief during neonatal immunization injections. Inclusion criteria were first year of age, breast-fed and no concurrent illness. Infants were divided into two groups (of 60 infants for each). One is intervention group: mothers were taken to a private room, seated and reclined on a comfortable chair with their infants awake in their arms, without cloth and with clean diapers. The mothers cradled their infants during breast-feeding to maintain full-body skin-to-skin contact during immunization injections. The other is control group: infants were observed during routine immunization in maternal & child health centres. Pain responses of infants during and after immunization were assessed by using Facial Pain Rating Scale and Neonatal/Infant Pain Scale (NIPS), before, during and after the procedure. Infants' heart rates and duration of crying for both groups were calculated. Findings revealed that the crying time was shorter in intervention (breast-fed) group than in the control group with a statistically significant difference in the duration of crying during and after immunization. We concluded that, breast-feeding and skin-to-skin contact significantly reduced crying in infants receiving immunization.     

肌肤接触安抚联合非营养性吸吮在新生儿操作性疼痛干预中的应用

目的:探讨肌肤接触安抚联合非营养性吸吮在新生儿操作性疼痛干预中的应用效果。方法:选取本院2018年2月—2019年2月入住新生儿监护病房的98例新生儿作为研究对象,随机分为A组32例、B组33例、C组33例,在对新生儿进行致痛性操作时,A组同时给予肌肤接触安抚和非营养性吸吮干预措施,B组只给予肌肤接触安抚措施,C组只给予非营养性吸吮干预措施。比较3组新生儿的疼痛量表(NIPS)评分和生命体征变化情况。结果:A组NIPS评分最低,且A组与B组或C组间比较差异都有统计学意义(P<0.05);A组与B组或C组的心率、呼吸状况、平均动脉压、血氧饱和度比较差异均有统计学意义(P<0.05),而B组、C组间差异并无统计学意义(P>0.05)。结论:肌肤接触安抚联合非营养性吸吮能缓解新生儿的操作性疼痛,并能维持生命体征的稳定,联合干预比单一干预措施效果更佳。