非营养性吸吮对足跟采血所致新生儿疼痛的影响

目的 探讨非营养性吸吮对足跟采血所致新生儿疼痛的影响,为新生儿疼痛管理提供参考依据.方法 将新生儿重症监护室中胎龄＞30周的新生儿随机分为干预组和对照组,干预组在足跟采血前和采血时给予非营养性吸吮,对照组在足跟采血过程不给予任何干预.观察足跟采血时两组新生儿的疼痛面容持续时间(s)、啼哭时间(s)、心率变化、足跟采血结束后30s内的啼哭人数.结果 足跟采血时干预组新生儿疼痛面容持续时间、啼哭时间较对照组明显缩短(P＜0.01),心率变化也明显小于对照组(P＜0.01);足跟采血结束后30s内,干预组新生儿的啼哭人数明显少于对照组(P＜0.01).结论 足跟采血时进行非营养性吸吮可减轻新生儿疼痛反应.     

母乳吸吮对足月新生儿足跟采血疼痛的影响

目的探索母乳吸吮对足月新生儿足跟采血疼痛的影响。方法便利抽取北京某医院产科病房60例接受足跟采血筛查的足月新生儿,随机分为两组,各30例。干预组新生儿在足跟采血前2min至采血结束后8min吸吮母乳。对照组按常规给予足跟采血。使用疼痛面容、啼哭、心率、血氧饱和度指标评估新生儿疼痛反应。结果干预组新生儿足跟针刺后疼痛面容和啼哭出现的时间晚于对照组(P0.05),啼哭人数少于对照组(P0.05),疼痛面容和啼哭的持续时间也短于对照组(P0.05),采血过程中和采血结束后1-4min的血氧饱和度均高于对照组(P0.05),采血结束后血氧饱和度的恢复时间也显著短于对照组(P0.05)。结论母乳吸吮能有效减轻足月新生儿足跟采血的疼痛程度。     

连续俯卧位干预措施缓解足跟采血致新生儿疼痛的研究

目的:研究采血期、采血恢复期连续俯卧位干预对足跟采血致新生儿疼痛的影响。方法:将100例足月正常新生儿随机分为干预组和对照组各50例。干预组在足底采血期取俯卧位、采血恢复期俯卧于母亲胸前,对照组按常规足底采血时取仰卧位,采血恢复期侧卧于婴儿床。观察两组新生儿足跟采血时的疼痛反应评分、采血期及采血恢复期疼痛面容持续时间、啼哭时间。结果:干预组在采血时新生儿疼痛反应评分低于对照组(P0.01);在采血期和采血恢复期啼哭持续时间、疼痛面容持续时间短于对照组(P0.01)。结论:连续俯卧位干预措施,可以显著缓解新生儿足跟采血时的急性疼痛,缩短新生儿在足跟采血期、采血恢复期的啼哭及疼痛面容的持续时间。     

综合疼痛干预减轻新生儿足跟采血急性疼痛刺激的效果

目的探讨综合疼痛干预减轻新生儿足跟采血急性疼痛刺激的效果。方法将100例新生儿随机分为对照组与干预组,每组各50例,对照组按常规进行足跟采血,干预组从足跟采血前5 min至采血结束后5 min实施综合疼痛干预措施。比较两组新生儿采血前30 s至采血后30 s心率及血氧饱和度、急性疼痛行为评分情况、采血时啼哭持续时间及疼痛面容持续时间。结果两组新生儿各项疼痛指标比较,均P0.001,差异具有统计学意义。干预组新生儿急性疼痛行为评分、采血时啼哭持续时间、疼痛面容持续时间明显少于或短于对照组;两组新生儿采血前30 s、采血后30 s心率及血氧饱和度比较,均P0.05,差异无统计学意义,采血时30 s新生儿心率比较,P0.01,差异具有统计学意义,干预组新生儿心率明显少于对照组。结论新生儿接受足跟采血时,采用婴儿辐射保暖台保暖、奶头吸吮、10%的葡萄糖水吸吮、抚摸、屈曲体位综合疼痛干预措施,能够有效减轻新生儿侵入性操作导致的急性疼痛行为反应。     

母乳喂养安抚措施缓解足跟采血所致新生儿疼痛的研究

目的探讨采血恢复期母乳喂养安抚措施对足跟采血所致新生儿疼痛的影响。方法将100例足月正常新生儿按随机数字表法分为干预组和对照组各50例。干预组足底采血时采取俯卧位,采血后立刻给予母乳喂养15分钟,伴随皮肤抚摸、言语安慰;对照组足底采血时也采取俯卧位,采血后侧卧于婴儿床,采血恢复期不给予任何干预措施。结果干预组采血恢复期哭泣持续时间、疼痛面容持续时间显著短于对照组（P〈0.01）;干预组采血恢复期不同时间段啼哭例数、依然存在疼痛面容的例数少于对照组（P〈0.05,P〈0.01）;两组在采血后24小时睡眠时间、惊醒次数、易于安抚方面差异有显著性意义（P〈0.01）。结论采血恢复期母乳喂养干预,能显著缩短新生儿足跟采血恢复期啼哭及疼痛面容持续时间,减少啼哭及依然存在疼痛面容的例数,增强新生儿采血后24小时睡眠时间,母婴交流,有利于新生儿的心理发育。     

非营养性吸吮对缓解早产儿操作性疼痛的影响

目的探讨非营养性吸吮对缓解早产儿操作性疼痛的影响。方法将2014年2月~2014年7月依据纳入和排除标准选取的120便早产儿随机分为实验组和对照组。实验组早产儿在接受足跟采血时至采血后5min给予非营养性吸吮。对照组按常规行足跟采血,不给予干预措施。观察并比较2组患儿心率、Sp O2、啼哭持续时间及疼痛评分情况。结果实验组早产儿针刺后的心率、Sp O2、啼哭持续时间及疼痛评分均优于对照组,比较差异有统计学意义(P0.05)。结论非营养性吸吮可缓解早产儿操作性疼痛、改善采血后的心率及Sp O2情况,并能缩短早产儿啼哭持续时间,值得在临床广泛推广应用。     

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。     

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。     

非营养性吸吮联合口服葡萄糖对新生儿置管疼痛的影响

目的:探讨非营养性吸吮联合口服葡萄糖对新生儿置管疼痛的影响。方法:将130例住院需行静脉置管的新生儿随机分为干预组和对照组各65例。干预组于操作前2 min口服1～2 ml葡萄糖液并将安慰奶头放入患儿口中至操作结束后;对照组按常规进行置管操作,不施加任何干预措施。采用新生儿疼痛量评分、疼痛面容持续时间、啼哭时间等指标评估比较两组新生儿疼痛反应的程度。结果:干预组患儿新生儿疼痛评分明显低于对照组(P<0.01),疼痛面容持续时间和啼哭持续时间较对照组明显缩短(P<0.01)。结论:非营养性吸吮联合口服葡萄糖能有效减轻新生儿置管疼痛的程度。     

两种干预方式缓解婴儿静脉留置针穿刺时疼痛的效果观察

[目的]探讨母乳吸吮、非营养性吸吮对婴儿接受静脉留置针穿刺时疼痛的干预效果。[方法]将在小儿内科病区住院的符合纳入标准的150例肺炎婴儿随机分为母乳吸吮组、非营养性吸吮组及对照组各50例,分别给予不同的干预措施后观察比较3组患儿在接受静脉留置针穿刺时疼痛面容出现的时间点及持续时间、啼哭例数及持续时间、心率和一次穿刺成功率。[结果]母乳吸吮组及非营养性吸吮组婴儿穿刺后疼痛面容出现的时间点均晚于对照组,持续时间短于对照组,差异具有统计学意义(P0.05);母乳吸吮组啼哭例数及啼哭持续时间少于对照组,差异有统计学意义(P0.05);一次穿刺成功率高于对照组,差异有统计学意义(P0.05)。两组穿刺时心率比较差异无统计学意义。[结论]母乳吸吮及非营养性吸吮能够有效减轻婴儿接受静脉留置针穿刺时引起的疼痛程度,提高婴儿静脉留置针一次穿刺成功率。     

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.     

Suckling- and sucrose-induced analgesia in human newborns

This experiment had three goals: 1. To identify the basis of sucking-induced analgesia in healthy, term, newborn humans undergoing the painful, routine, procedure of heel lance and blood collection. 2. To evaluate how taste-induced and sucking-induced analgesias combine to combat pain. 3. To determine whether facial grimacing was an accurate index of diminished pain, or whether it was linked to tissue trauma. We report that: 1. Sucking an unflavored pacifier was analgesic when and only when suck rate exceeded 30 sucks/min. 2. The combination of sucrose and nonnutritive sucking was remarkably analgesic; we saw no behavioral indication in nine of the ten infants that the heel lance had even occurred. 3. Grimacing was reduced to almost naught by procedures that essentially eliminated crying and markedly reduced heart rate during the blood harvesting procedure.     

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。     

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。     

不同干预方法减轻婴幼儿预防接种注射疼痛的效果

目的探讨不同干预方法减轻婴幼儿预防接种注射疼痛的效果。方法便利抽样法选择2011年1-4月在北京某社区保健院进行预防接种的6～12个月龄婴幼儿144例为研究对象,按随机数字表法将其分为4组,每组36例。对照组采用常规接种法,其他三组在常规接种方法上分别采用音乐干预、音乐联合舒适体位及舒适体位方法进行干预。采用改良婴儿疼痛程度评估表(pain intensity evaluation sheet,MBPS)、哭闹时间及心率变化等指标对婴幼儿疼痛进行评价。结果音乐干预组、舒适体位组以及音乐联合舒适体位组婴幼儿与对照组婴幼儿在MBPS指标上的差异有统计学意义(P<0.05);音乐干预组、舒适体位组以及音乐联合舒适体位组婴幼儿在哭闹持续时间、心率变化方面的差异有统计学意义(P<0.05)。结论在婴幼儿预防接种时进行音乐干预、音乐联合舒适体位、舒适体位干预可不同程度地降低婴儿预防注射时的疼痛感,从而减轻注射疼痛对婴儿的不良影响。三种干预方法中,音乐干预配合舒适体位减轻6～12个月婴幼儿预防接种疼痛效果最佳。     

音乐干预对发热足月新生儿静脉注射疼痛的影响

目的 探讨音乐干预对发热足月新生儿静脉注射疼痛的影响.方法 在我科住院的需静脉注射的发热足月新生儿60例随机分为观察组和对照组,每组30例.观察组新生儿在静脉注射进针前10min至进针后5 min进行音乐干预,对照组无音乐干预.使用疼痛面容、啼哭、心率指标和血氧饱和度等评估新生儿疼痛反应.结果 观察组新生儿静脉注射进针后疼痛面容和啼哭出现的时间晚于对照组(P＜0.05).啼哭人数少于对照组(P＜0.05),疼痛面容和啼哭的持续时间也短于对照组(P＜0.05),进针过程和进针后1～5 min的血氧饱和度高于对照组(P＜0.05),进针后血氧饱和度的恢复时间也显著短于对照组(P＜0.05).结论 音乐干预能有效减轻发热足月新生儿静脉进针的疼痛程度.     

足跟采血致新生儿疼痛的护理干预效果研究

目的 研究足跟采血致新生儿疼痛反应的护理干预效果.方法 将180例正常足月新生儿分为实验组和对照组,各90例.对照组取仰卧位,在致痛操作全过程不给予任何干预;实验组采取屈曲体位+非营养性吸吮(NNS).采用新生儿急性疼痛行为评分量表(DAN)与采血结束后30s内停止啼哭的例数比较对新生儿疼痛进行评估.结果 实验组的疼痛评分明显低于对照组,差异有统计学意义(P＜0.01).实验组采血结束后30 s内的停止啼哭例数明显多于对照组,差异有统计学意义(P＜0.01).结论 护理干预能有效地缓解新生儿足跟采血所致的疼痛.     

Pain in infancy: neonatal reaction to a heel lance

A combined single subject and group design was used to investigate changes in heart rate and crying in response to a heel lance, non-invasive tactile stimulation and baseline periods in 10 male and 10 female infants, each in their second full day of life. Heart rate was measured with an electrocardiogram. Percentage of time crying was computed from observations of audiotapes. Results for individual subjects indicated that heart rate and percentage of crying were consistently increased by the heel lance but that there was often wide baseline variability in the two measures. Analysis of variance indicated that responses to heel lance were higher than responses to tactile stimulation which were in turn higher than responses to baseline for both heart rate and percentage of crying (P less than 0.01). No significant sex differences were found. It was suggested that the increases in heart rate and crying in the context of a tissue damaging stimulus indicated that the infants experienced pain and that pain in infants can be reliably measured in clinical settings.     

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。