两种干预方式缓解早产儿足跟采血疼痛的效果分析

目的比较口服葡萄糖液与口服葡萄糖液联合非营养性吸吮对早产儿足跟采血疼痛的干预效果。方法选择在新生儿科住院的早产儿90例,随机分为葡萄糖组、葡萄糖加非营养性吸吮组及对照组,采用早产儿疼痛量表（PIPP）,观察各组早产儿对疼痛的反应。结果葡萄糖组、葡萄糖加非营养性吸吮组早产儿疼痛量表（PIPP）评分显著低于对照组;葡萄糖加非营养性吸吮组早产儿疼痛量表（PIPP）评分显著低于葡萄糖组。结论口服葡萄糖液或口服葡萄糖液联合非营养性吸吮均能减轻早产儿足跟采血的疼痛。口服葡萄糖液联合非营养性吸吮对口服葡萄糖液的止痛效果有加强作用。     

两种干预方式缓解新生儿静脉穿刺疼痛的效果研究

[目的]比较非营养性吸吮与非营养性吸吮+口服葡萄糖水对新生儿静脉穿刺疼痛的干预效果.[方法]选择在我科住院的足月新生儿90例,随机分为非营养性吸吮组、非营养性吸吮+口服葡萄糖水组及对照组,观察3组静脉穿刺时及穿刺后5 min新生儿疼痛行为评分(NIPS).[结果]非营养性吸吮组、非营养性吸吮+口服葡萄糖水组新生儿NIPS评分显著低于对照组;非营养性吸吮+口服葡萄糖水组NIPS评分显著低于非营养性吸吮组.[结论]非营养性吸吮或非营养性吸吮+口服葡萄糖水均能减轻新生儿静脉穿刺时疼痛.     

非营养性吸吮对缓解足跟采血所致新生儿疼痛的效果观察

目的:探讨非营养性吸吮对有效缓解新生儿足跟采血所致疼痛的效果。方法:选择我院进行足跟采血检验的新生儿作为研究对象并随机等分为对照组和研究组,对照组给予口中滴注葡萄糖溶液,研究组新生儿给予葡萄糖溶液吸吮后进行非营养性吸吮。采用新生儿疼痛评分量表(NIPS)和新生儿面部编码系统评分简表(NFCS)评估两组新生儿疼痛情况。结果:采血中及采血后研究组新生儿NIPS评分以及NFCS评分均低于对照组,差异具有统计学意义(P0.05)。结论:针对接受足跟采血新生儿予以非营养性吸吮,可以有效缓解其足跟采血所至的疼痛刺激,减轻新生儿痛苦。     

早产儿足跟采血干预方法缓解疼痛的对比研究

目的:探讨不同干预方式对早产儿足跟采血的疼痛缓解程度的区别。方法:选择2013年7月至2013年12月入住我院的早产儿156名进行完全随机分组,分为观察组A、观察组B、观察组C、对照组,观察组分别进行非营养性吸吮、营养补充性吸吮、抚触干预,对照组无安慰措施,根据早产儿对足跟采血穿刺过程中以及穿刺结束5 min后的疼痛评分(依据早产儿疼痛评分简表评测)和面部表情评分法进行评价,对比各组新生儿的评分情况进行分析。结果:观察组3个小组患儿在足跟采血的穿刺过程中,PIPP量表评分均低于6分,不需要镇痛治疗;在穿刺结束5 min后,其量表评分均有所降低,比对照组明显减轻;3个观察组患儿的疼痛表情均明显低于对照组评分;且观察组B的患儿评分几乎等于0,其面部表情评分最低,疼痛指数更佳,效果更好(P<0.05)。结论:通过对早产儿足跟采血进行不同的干预方法,对于疼痛均具有缓解作用,应用营养性吸吮效果更佳,临床中可以根据患儿具体情况,选择更合适的干预措施。     

新生儿重症监护病房新生儿疼痛的评估及干预

目的研究新生儿重症监护病房对新生儿疼痛的评估,分析相关的干预措施的影响。方法将患儿分为对照组(不作处理)、NNS组(非营养性吸吮)、NNS+GS组(非营养性吸吮加葡萄糖)。3组患儿在桡动脉处进行穿刺,并在穿刺前、中、后期使用多参数心电监护仪对患儿的心率、呼吸频率、经皮氧饱和度进行监测。使用疼痛评分简表(PIPP)对各组新生儿患者的疼痛进行评估。结果对照组的一次穿刺成功率低于NNS组及NNS+GS组,NNS组的一次穿刺成功率低于NNS+GS组(P0.05);对照组PIPP评分高于NNS组、NNS+GS组,NNS+GS组PIPP评分低于NNS组(P0.05);患儿桡动脉穿刺时的心率、呼吸均加快,Sp O2降低(P0.05),其中NNS组及NNS+GS组干预后心率、呼吸、Sp O2的变化比对照组小(P0.05),且可较快恢复至穿刺前。结论心率、呼吸频率、经皮氧饱和度可作为评估新生儿疼痛的生理性指标,PIPP评分能够简便评估疼痛。非营养性吸吮、非营养性吸吮结合葡萄糖均能缓解新生儿疼痛,但非营养性吸吮结合葡萄糖止痛效果更好,临床上可推广使用。     

非营养性吸吮对静脉穿刺新生儿疼痛的影响

目的探讨非营养性吸吮对静脉穿刺新生儿疼痛的影响,为新生儿疼痛管理提供参考依据。方法将204例静脉穿刺新生儿（其中102例为早产儿,102例为足月儿）随机分为A、B、C、D四组,A、B两组为早产儿．C、D两组为足月儿。A组早产儿给予非营养性吸吮;B组早产儿不给予任何干预;C组足月儿给予非营养性吸吮;D组足月儿不给予任何干预。采用新生儿疼痛评分（NIPS）,观察各组新生儿对疼痛的反应。结果静脉穿刺时A、C两组新生儿疼痛评分明显低于B、D两组,P〈0．01。结论静脉穿刺时进行非营养性吸吮可明显减轻新生儿疼痛反应,值得临床推广应用。     

不同护理干预方法对减轻足月新生儿足跟采血疼痛的影响

目的探讨不同护理干预方法对减轻足月新生儿足跟采血疼痛的影响。方法将183例接受足跟采血的足月新生儿随机分为对照组、拥抱组和母乳吸吮组各61例。对照组采用常规足跟采血方法,拥抱组母亲抱着新生儿采血,母乳吸吮组在足跟采血前2min由母亲给新生儿哺乳。比较3组新生儿啼哭出现时间与持续时间、新生儿面部编码系统(NFCS)评分及新生儿急性疼痛行为量表(DAN)评分。结果母乳吸吮组足跟针刺后啼哭出现时间与持续时间晚于/短于拥抱组和对照组,采血过程中、采血后1min和2min的NFCS评分明显低于拥抱组和对照组,采血过程中3个维度的DAN评分均明显低于拥抱组和对照组;而拥抱组和对照组上述指标比较,差异均无统计学意义。结论母乳吸吮能有效减轻足月新生儿足跟采血所致的疼痛,而拥抱对其无效。     

非药物治疗缓解新生儿疼痛的护理干预

目的探讨非药物治疗缓解新生儿疼痛的有效方法。方法将150例住院新生儿随机分为空白对照组、非营养性吸吮组和拥抱安抚组,每组各50例,在疼痛刺激(采足跟血)前、刺激后20s、1min、3min分别记录新生儿的心率、呼吸、经皮血氧饱和度及哭闹持续时间,并在刺激1min后根据新生儿面部编码系统(neontal facial coding system,NFCS)、新生儿疼痛评估量表(neonatal infant pain scale,NIPS)进行疼痛评分。结果穿刺后20s,各组新生儿心率、呼吸与穿刺前差异均有统计学意义(P0.01或0.05);穿刺后1min,各组新生儿呼吸频率均比穿刺前明显加快,差异有统计学意义(P0.05),NNS组和拥抱安抚组心率恢复至穿刺前水平;穿刺后2min,NNS组和拥抱安抚组呼吸频率恢复至穿刺前水平;各组新生儿经皮血氧饱和度穿刺前后差异均无统计学意义(P0.05);NNS组和拥抱安抚组新生儿穿刺后哭闹持续时间均短于对照组(P0.01),且拥抱安抚组又短于NNS组(P0.05);穿刺后NNS组和拥抱安抚组的NFCS和NIPS评分均低于对照组(P0.01)。结论新生儿对急性疼痛很敏感,非营养性吸吮和拥抱安抚对新生儿均有明显的止痛作用。在临床护理中可采用以上非药物干预措施缓解新生儿的疼痛。     

口服蔗糖加非营养性吸吮对新生儿疼痛的影响

目的探讨口服24%蔗糖溶液加非营养性吸吮缓解新生儿疼痛的效果。方法将患有高胆红素血症的足月新生儿100例按入院时间、性别随机分为对照组和干预组,各50例。干预组在接受静脉穿刺前2 min口服24%蔗糖溶液2 mL,同时给予非营养性吸吮;对照组在穿刺过程中不给予任何缓解疼痛的干预措施。观察2组新生儿静脉穿刺时的疼痛程度,并记录啼哭持续时间以及心率、呼吸和血氧饱和度的变异率。结果干预组的新生儿面部编码系统(NFCS)和新生儿疼痛评估量表(NIPS)评分和啼哭时间显著小于对照组,差异有统计学意义(P<0.01),干预组的心率、呼吸及血氧饱和度变异率显著小于对照组,差异有统计学意义(P<0.01)。结论口服蔗糖加非营养性吸吮可显著缓解新生儿疼痛。     

抚触和非营养性吸吮对新生儿足跟采血时疼痛程度的影响研究

目的:观察抚触和非营养性吸吮对新生儿足跟采血时心率和疼痛程度的影响,探索有效缓解新生儿疼痛的方法。方法:将150例住院新生儿随机分为3组:对照组、应用非营养性吸吮组和抚触组,每组50例,观察足跟采血时各组心率的变化,并应用新生儿疼痛量表进行疼痛程度评分。结果:足跟采血时,各组新生儿的心率均显著加快,与对照组比较,非营养性吸吮和抚触干预措施均可缓解疼痛刺激引起的心率和评分变化,差异有显著性意义(P<0.01)。结论:不同的干预方法对缓解新生儿疼痛的近期效果不同,非营养性吸吮缓解疼痛效果优于抚触组。     

非营养性吸吮缓解新生儿疼痛的临床研究

目的探讨非营养吸吮(NNS)缓解新生儿疼痛的临床有效性及可行性,为NNS在新生儿病房的推广提供依据。方法患儿分为NNS组40例,对照组40例。选用新生儿急性疼痛行为评分量表(DAN)对接受足跟取血的80例新生儿进行疼痛评分。结果对照组患儿疼痛总分为8.03±1.74分,NNS组患儿疼痛总分为4.68±1.54分,NNS组患儿在面部表情、肢体活动、声音表现各方面得分均有显著下降,各方面得分差异均具有显著意义(P<0.01),NNS组和对照组患儿疼痛得分与其性别、胎龄、日龄及体重等均无显著关系(P>0.05)。结论应重视新生儿疼痛的管理,NNS操作简单,镇痛效果良好,对在临床工作中缓解新生儿疼痛具有良好的实用性。     

Non-nutritive sucking,oral breast milk,and facilitated tucking relieve preterm infant pain during heel-stick procedures: A prospective,randomized controlled trial

BackgroundPreterm infant pain can be relieved by combining non-nutritive sucking (sucking), oral sucrose, and facilitated tucking (tucking), but the pain-relief effects of oral expressed breast milk (breast milk) are ambiguous.AimsWe compared the effects of combined sucking+ breast milk, sucking + breast milk + tucking, and routine care on preterm infant pain during and after heel-stick procedures.DesignA prospective, randomized controlled trial.SettingsLevel III neonatal intensive care unit and a neonatal unit at a medical center in Taipei.Participants/subjectsPreterm infants (N = 109, gestational age 29–37 weeks, stable disease condition) needing procedural heel sticks were recruited by convenience sampling and randomly assigned to three treatment conditions: routine care, sucking+ breast milk, and sucking + breast milk + tucking.MethodsPain was measured by watching video recordings of infants undergoing heel-stick procedures and scoring pain at 1-min intervals with the Premature Infant Pain Profile. Data were collected over eight phases: baseline (phase 1, 10 min without stimuli before heel stick), during heel stick (phases 2 and 3), and a 10-min recovery (phases 4–8).ResultsFor infants receiving sucking+ breast milk, pain-score changes from baseline across phases 2–8 were 2.634, 4.303, 2.812, 2.271, 1.465, 0.704, and 1.452 units lower than corresponding pain-score changes of infants receiving routine care (all p-values < 0.05 except for phases 6 and 7). Similarly, for infants receiving sucking +breast milk+ tucking, pain-score changes from baseline were 2.652, 3.644, 1.686, 1.770, 1.409, 1.165, and 2.210 units lower than corresponding pain-score changes in infants receiving routine care across phases 2–8 (all p-values < 0.05 except for phase 4). After receiving sucking +breast milk +tucking and sucking +breast milk, infants’ risk of mild pain (pain score ≥6) significantly decreased 67.0% and 70.1%, respectively, compared to infants receiving routine care. After receiving sucking +breast milk +tucking and sucking +breast milk, infants’ risk of moderate-to-severe pain (pain score ≥12) decreased 87.4% and 95.7%, respectively, compared to infants receiving routine care.ConclusionThe combined use of sucking + breast milk +tucking and sucking + breast milk effectively reduced preterm infants’ mild pain and moderate-to-severe pain during heel-stick procedures. Adding facilitated tucking helped infants recover from pain across eight phases of heel-stick procedures. Our findings advance knowledge on the effects of combining expressed breast milk, sucking, and tucking on preterm infants’ procedural pain.     

Effect of non-nutritive sucking on pain during the examination of retinopathy of prematurity

BackgroundThe eye examination of Retinopathy of Prematurity is a painful procedure for premature infants. Non-nutritive sucking is an effective non-pharmacologic method for reducing pain levels in premature infants utilized in most neonatal intensive care units across the globe.AimThis study investigated the effect of non-nutritive sucking on infants’ pain levels during retinopathy of prematurity eye examinations.MethodsThe study is a randomized controlled trial consisting of 60 premature infants (30 randomized to the control group and 30 to the intervention group) undergoing an eye examination related to retinopathy of prematurity. Premature infants in the control group did not receive NNS. Premature infants in the intervention group received non-nutritive sucking with a gloved-finger. The evaluation of pain levels in premature infants used the Premature Infant Pain Profile for 60 s before the eye examination, 30 s during the eye examination, and 30 s at the conclusion of the ROP eye examination. The clinical trial registration number of the study is NCT04463927.ResultsA statistically significant difference was found between the control and intervention groups of premature infants in terms of pain levels during and after the eye examinations for retinopathy of prematurity (p < .001). Pain scores were significantly lower in the intervention group during and after the retinopathy of prematurity eye examinations compared to the control group.     

Effect of non-nutritive sucking and sucrose alone and in combination for repeated procedural pain in preterm infants: A randomized controlled trial

BackgroundSucrose combined with non-nutritive sucking provided better pain relief than sucrose or non-nutritive sucking alone in a single painful procedure. However, whether the combination of non-nutritive sucking with sucrose could obtain a significant difference in analgesic effect of the repeated procedural pain than any single intervention has not been established.ObjectiveTo compare the effect of non-nutritive sucking and sucrose alone and in combination of repeated procedural pain in preterm infants.DesignRandomized controlled trial.SettingA level III neonatal intensive care unit of a university hospital in China.MethodPreterm infants born before 37 weeks of gestation were randomly assigned to four groups: routine care group (routine comfort through gentle touch when infants cried; n = 21), non-nutritive sucking group (n = 22), sucrose group (0.2 ml/kg of 20%; n = 21), sucrose (0.2 ml/kg of 20%) plus non-nutritive sucking group (n = 22). Each preterm infant received three nonconsecutive routine heel sticks. Each heel stick included three phases: baseline (the last 1 min of the 30 min without stimuli), blood collection, recovery (1 min after blood collection). Three phases of 3 heel stick procedures were videotaped. Premature infant pain profile (PIPP) score, heart rate, oxygen saturation and percentage of crying time were assessed by five independent evaluators who were blinded to the purpose of the study at different phases across three heel sticks. Data were analyzed by analysis of variance, with repeated measures at different evaluation phases of heel stick.Results86 preterm infants completed the protocol. During the blood collection and recovery phases, combination group, had lower PIPP score (4.4 ± 1.5; 3.0 ± 0.8), lower heart rate (138.6 ± 7.9; 137.4 ± 4.7), higher oxygen saturation (95.2 ± 1.6; 96.0 ± 1.2), and smaller percentage of crying time (11.5 ± 8.6; 4.6 ± 3.4), compared with the group has given non-nutritive sucking (9.3 ± 1.3, 6.8 ± 1.4; 154.2 ± 9.0, 148.0 ± 9.3; 92.9 ± 2.4, 94.1 ± 1.0; 44.2 ± 9.6, 31.2 ± 10.5; respectively) or sucrose (10.1 ± 2.0, 7.4 ± 1.6; 151.6 ± 9.6, 147.9 ± 6.9; 93.5 ± 1.7, 94.5 ± 1.2; 53.8 ± 16.7, 35.2 ± 13.9; respectively) or routine care (13.3 ± 1.6, 10.6 ± 1.9; 156.8 ± 7.2, 151.7 ± 7.9; 92.9 ± 2.1, 93.8 ± 1.6; 80.6 ± 7.6, 68.2 ± 9.9; respectively). Both non-nutritive sucking and sucrose were more effective in reducing preterm infants’ PIPP score and percentage of crying time than routine care. There was no difference in PIPP score, heart rate, oxygen saturation and percentage of crying time between the non-nutritive sucking and sucrose groups.ConclusionThe combination of non-nutritive sucking with sucrose provided better pain relief during repeated painful procedures than when non-nutritive sucking or sucrose was used alone. The effect of non-nutritive sucking was similar to that of sucrose on repeated procedural pain.     

音乐疗法干预在减轻手外伤患者疼痛方面的作用

目的 探讨音乐疗法在减轻手外伤患者疼痛中的作用及临床价值. 方法 采用随机抽选方法,选取2012年1月至2013年1月来我院就诊的60例手外伤患者,随机将其分为对照组和实验组. 对照组患者在安静状态下休息30 min,实验组患者采用音乐疗法30 min. 比较两组患者在安静或音乐疗法前后的生理指标及心理反应变化情况. 结果 实验组患者心率、呼吸、收缩压、舒张压及疼痛得分均明显优于对照组( P<0. 05 ). 结论 音乐疗法应用于外科手外伤患者的护理过程中,可减轻患者的疼痛及平缓生理指标,从而减轻焦虑,值得临床推广应用.     

音乐干预对上腹部手术患者疼痛影响的研究

目的探讨音乐干预对上腹部手术患者术后疼痛的影响。方法对60例上腹部手术患者进行音乐干预,在音乐干预前及音乐干预20min、40min、60min时采用疼痛数字分级法进行疼痛评分及心电监护仪监测呼吸、脉搏、血压。结果音乐干预后疼痛评分较干预前下降,随着干预时间延长,疼痛缓解越明显。音乐干预后呼吸及脉搏减慢、血压下降。结论音乐干预对上腹部手术后疼痛有缓解作用。     

非营养性吸吮在早产儿喂养中的应用研究

目的:探讨非营养性吸吮在早产儿喂养中的应用及其效果。方法:将38例需经鼻胃管喂养的健康早产适于胎龄儿用同一种配方乳喂养。将其随机分为非营养性吸吮组18例和营养性吸吮组20例。营养性吸吮组给予单纯鼻胃管营养,非营养性吸吮组在此基础上给予无孔橡皮奶头吸吮。记录入液量、奶量、热卡和肠道营养达418.4kJ/(kg.d)的时间,记录喂养相关情况。结果:非营养性吸吮组胃残留发生率低于营养性吸吮组(P0.01);喂养耐受情况优于营养性吸吮组(P0.05);肠道营养达418.4kJ/(kg.d)的时间、恢复出生体重时间、反流次数均少于营养性吸吮组(P0.05或P0.01);鼻饲管留置时间两组无统计学差异(P0.05)。结论:鼻胃管喂养期间给予非营养性吸吮是一种简单而安全的喂养方式,可促进胃排空,减少胃食管反流次数,对胃肠动力发育有促进作用,有助于早产儿生后肠道营养的建立。     

母乳吸吮干预对婴儿静脉穿刺疼痛的影响

目的探讨母乳吸吮时机对婴儿静脉穿刺疼痛的影响。方法随机把符合条件的入院患儿分成干预组与对照组各60例。干预组在操作前暂禁母乳喂养2～3h,在静脉穿刺时给予母乳吸吮干预。对照组按常规给予静脉穿刺。通过检测患儿啼哭时间、心率、血氧饱和度来评估患儿的疼痛程度。结果干预组静脉穿刺患儿啼哭持续时间均少于对照组,差异具有统计学意义（Z=-4．405,P〈0．05）,血氧饱和度均高于对照组,差异具有统计学意义（P〈0．01）。结论母乳吸吮干预可有效减轻婴儿静脉穿刺疼痛程度。