两种非药物性干预法缓解早产儿静脉穿刺疼痛的效果观察

[目的]探讨非营养性吸吮和口服10%葡萄糖缓解早产儿静脉穿刺疼痛的效果。[方法]将240例住院早产儿按入院先后顺序随机分为对照组、NNS组和GS组,每组80例,早产儿静脉穿刺过程中,对照组不做任何干预,NNS组吸吮安慰奶嘴,GS组口服10%葡萄糖水,比较3组早产儿静脉穿刺时疼痛评分及啼哭发生情况,疼痛评分采用加拿大Toronto和McGill大学研制的早产儿疼痛评分量表(PIPP)。[结果]对照组、NNS组和GS组静脉穿刺时PIPP评分分别为10.34分±1.69分、5.98分±1.63分、5.54分±1.52分,NNS组和GS组PIPP评分低于对照组(P0.05),NNS组和GS组PIPP评分差异无统计学意义(P0.05);3组静脉穿刺时早产儿啼哭发生率分别为73.75%、52.50%、47.50%,NNS组和GS组发生率低于对照组(P0.05),NNS组和GS组啼哭发生率差异无统计学意义(P0.05)。[结论]非营养性吸吮和口服10%葡萄糖均能一定程度地缓解静脉穿刺疼痛,医护人员可根据早产儿的实际情况选择合适的非药物干预方法。     

不同护理干预方法对新生儿桡动脉采血时疼痛和生命体征的影响

目的 探讨非药物干预,包括非营养性吸吮和葡萄糖糖水口服,对新生儿桡动脉采血时疼痛及生命体征的影响.方法 106例住院新生儿随机分为非营养性吸吮(non-nutritive sucking,NNS)组、糖水组和对照组,分别于采血时给予安慰奶嘴吸吮、10%葡萄糖10～20 ml 口服以及不给予任何干预方法.各组在进行桡动脉穿刺采血时应用"新生儿急性疼痛行为评分量表"进行疼痛评分,并应用多功能监护仪动态记录穿刺前、穿刺中及穿刺后的生命体征和经皮血氧饱和度等指标的变化.结果 在进行桡动脉穿刺采血时,3组新生儿疼痛评分差异有统计学意义(F=47.847,P=0.000),其中对照组明显高于NNS组和糖水组,而NNS组和糖水组之间差异无统计学意义.3组新生儿的生命体征参数变异率差异有统计学意义,其中NNS组和糖水组的变异率均低于对照组(P=0.000),NNS组和糖水组之间无统计学意义.结论 新生儿在进行桡动脉穿刺时,给予非营养性吸吮或喂食糖水可以减轻其疼痛反应,同时减少生命体征的波动.     

非营养性吸吮对静脉抽血所致新生儿疼痛的影响

目的探讨非营养性吸吮对静脉抽血所致新生儿疼痛的影响。方法将120例新生儿随机编入非营养性吸吮(NNS)组和对照组,每组60例。在穿刺过程中非营养性吸吮组新生儿吸吮安慰奶嘴,对照组只进行静脉抽血穿刺操作。记录2组新生儿在穿刺前2min、穿刺过程中及穿刺后1min、5min心率、血氧饱和度及疼痛评分,同时记录新生儿哭泣时间及白细胞数、C-反应蛋白、肌酸激酶活性,并对所获数据进行统计学分析。结果在静脉采血时、采血后1 min,NNS组患儿的心率增幅显著小于对照组,经皮血氧饱和度降低显著小于对照组,疼痛评分小于对照组,差异有统计学意义(P0.05);NNS组哭泣时间小于对照组,差异有统计学意义(P0.05);NNS组白细胞数、C-反应蛋白、肌酸激酶活性小于对照组,差异有统计学意义(P0.05)。结论非营养性吸吮(NNS)可以降低新生儿在静脉抽血时的疼痛,并能降低抽血过程中其白细胞数、C-反应蛋白、肌酸激酶活性的升高。     

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。     

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。     

应用非营养性吸吮缓解早产儿静脉穿刺疼痛

目的:探讨使用非营养性吸吮在缓解早产儿静脉穿刺痛中的镇痛效果。方法:选取2014年8月~2015年1月我院住院早产儿160例,随机等分为对照组和非营养性吸吮(NNS)组,对照组按常规进行静脉穿刺,NNS组每次静脉穿刺时使用安慰奶嘴,比较两组早产儿进行3次静脉穿刺时的疼痛评分情况。疼痛评分采用加拿大Toronto和Mc Gill大学研制的早产儿疼痛评分量表(PIPP)。结果:NNS组静脉穿刺时的PIPP评分均低于对照组,差异有统计学意义(P0.05)。结论:早产儿静脉穿刺时多次使用非营养性吸吮干预方法有镇痛效果。     

早产儿眼底筛查中口服25%葡萄糖镇痛的效果评价

目的:探讨口服25%葡萄糖在早产儿视网膜病眼底筛查时的镇痛效果。方法:选取2015年11月1日~2016年10月30日在我市新生儿科住院治疗的303例早产儿作为研究对象,随机分为3组,观察组(25%葡萄糖吸吮组,103例)、NNS组(非营养吸吮组,100例)、对照组(无干预组,100例)。以早产儿疼痛评分量表(PIPP)评分结果,评估早产儿疼痛程度。结果:对照组在筛查后PIPP评分均高于观察组及NNS组,差异有统计学意义(P0.05)。观察组与NNS组比较,筛查后观察组PIPP评分低于NNS组,差异有统计学意义(P0.05)。结论:无论是口服25%葡萄糖或非营养性吸吮的措施,均能降低早产儿疼痛反应。而口服25%葡萄糖更能减轻疼痛反应,镇痛效果优于单纯的非营养性吸吮。     

非营养性吸吮在新生儿桡动脉采血护理中的应用效果评价

目的探讨非营养性吸吮在新生儿桡动脉采血护理中的应用效果。方法选取2018年1月—5月本院新生儿科收治70例需行桡动脉采血的患儿为研究对象,将其根据随机对照原则分为对照组和观察组,每组各35例。对照组采取常规桡动脉采血,观察组在对照组的基础上采用非营养性吸吮。比较两组患儿的一次性穿刺采血成功率、生命体征变异阳性率、并发症发生率、采血操作时间、疼痛评分以及患儿家属护理满意度。结果观察组的一次性穿刺采血成功率高于对照组,生命体征变异阳性率及并发症发生率均低于对照组,差异均有统计学意义(P0.05);观察组的采血操作时间较对照组短(P0.05),疼痛评分低于对照组(P0.05);观察组患儿家属的护理总满意度高于对照组,差异有统计学意义(P0.05)。结论采用非营养性吸吮能够提高新生儿桡动脉采血成功率,减轻患儿疼痛,降低并发症发生率,提高护理满意度,值得临床推广。     

母亲声音联合非营养性吸吮在新生儿疼痛管理中的应用

目的:观察并比较非营养性吸吮(NNS)、母亲声音(MV)、母亲声音联合非营养性吸吮(MV+NNS)在缓解新生儿足跟采血时疼痛的效果。方法:选取2017年12月至2018年10月在青岛大学附属医院新生儿科住院的患儿120例,按随机原则分为空白对照组和干预组(包括NNS组、MV组和MV+NNS组)各30例。对照组行常规护理措施,干预组在常规护理措施基础上给予干预,干预时间从足跟采血前5 min开始至采血结束后10 min。应用新生儿疼痛评估量表(NIPS)对四组新生儿分别进行评分,判断新生儿疼痛程度;观察新生儿心率、血氧饱和度的波动情况。结果:患儿足跟采血期间均出现心率增快、血氧饱和度降低的情况,干预组与空白对照组之间心率、血氧饱和度差异有统计学意义(P<0.05),其中MV+NNS组心率、血氧饱和度变化幅度最小,较其他三组比较,差异有统计学意义(P<0.05);干预组啼哭人数及NIPS评分均少于空白对照组,差异有统计学意义(P<0.05)。MV+NNS组在啼哭人数及NIPS评分上与其他三组比较,差异有统计学意义(P<0.05)。结论:母亲声音联合非营养性吸吮可明显缓解新生儿的疼痛反应,大大降低新生儿的疼痛程度,无不良反应的发生,在新生儿的临床护理工作中具有十分重要的意义。     

非营养性吮吸对新生儿疼痛干预效果的研究

目的 探讨减轻新生儿疼痛的非药物疗法.方法 将住院的100例新生儿随机分为未干预组和应用非营养性吮吸(NNS)组,在进行静脉采血过程中,采用新生儿疼痛评估量表(NIPS)对两组新生儿进行评分,同时监测采血前后心率、呼吸、SpO2改变.结果 NNS组在采血时,对疼痛的反应明显轻于未干预组,其差异具有统计学意义(P＜0.0...     

2种干预方式对新生儿疼痛影响的研究

目的 比较音乐干预与音乐+非营养性吸吮干预合用对足跟采血所致新生儿疼痛的干预效果.方法 将新生儿重症监护室中胎龄≥28周的75例新生儿随机分为音乐干预组、音乐+非营养性吸吮组及对照组,察足跟采血时3组新生儿啼哭和疼痛面容的持续时间、心率(HR)和血氧饱和度(SpO2)的变化、采血结束后90 s内的啼哭例数.结果 音乐干预组、音乐+非营养性吸吮组的新生儿疼痛面容和啼哭的持续时间、HR和SpO2恢复至采血前基线水平所需的时间均显著短于对照组,HR、SpO2的变化幅度显著低于对照组;乐+非营养性吸吮组新生儿的啼哭、疼痛面容的持续时间、HR恢复至采血前基线水平所需的时间均显著短于音乐组的新生儿.结论 足跟采血时音乐干预或音乐+非营养性吸吮合用均能减轻新生儿疼痛.音乐干预+非营养性吸吮合用对音乐干预的止痛效果有加强作用.     

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.     

非营养性吸吮对早产低出生体重儿体格生长的影响研究

目的研究非营养性吸吮对早产低出生体重儿体格生长的临床效果,并探讨管饲前、中、后分别给予非营养性吸吮对其效果有无差异。方法应用简单随机方法将120例早产低出生体重儿分为四组,即A组、B组、C组和D组。A组为对照组,给予早产儿常规治疗和护理;B组、C组和D组为干预组,分别在管饲前、管饲喂养过程中以及管饲后给予非营养性吸吮,记录各组的体格生长指标。结果四组早产低出生体重儿的体质量增长速度、住院时间差异无统计学意义(P0.05);4组早产低出生体重儿的身长和头围增长速度、恢复至出生体重的时间差异有统计学意义(P0.05)。经两两比较得出:A组与B组、C组、D组差异均有统计学意义(P0.05);B组、C组和D组三组各组间差异无统计学意义(P0.05)。结论非营养性吸吮能促进早产低出生体重儿身长和头围的生长,缩短恢复至出生体质量的时间,加快体格生长;管饲前、中、后给予非营养性吸吮,对早产低出生体重儿体格生长的影响效果并无差异,护理人员可合理安排对早产低出生体重儿实施非营养性吸吮。     

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。     

音乐干预配合非营养性吸吮在小儿头皮静脉穿刺中的应用

目的 探讨音乐干预配合非营养性吸吮在小儿头皮静脉穿刺中的应用方法及效果.方法 将200例0～1岁的需静脉输液的患儿随机分为试验组和对照组,对照组采取常规方法静脉穿刺,试验组在此基础上实施音乐干预配合非营养性吸吮.比较两组穿刺时患儿的疼痛的程度及一次穿刺的成功率.结果 试验组穿刺时疼痛程度比对照组轻（P＜0.01）,试验组一次性穿刺成功率高于对照组（P＜0.01）.结论 音乐干预配合非营养性吸吮能有效减轻患儿静脉穿刺时的疼痛,提高了静脉穿刺一次成功率.     

口服葡萄糖加非营养性吸吮缓解新生儿疼痛

目的探讨口服葡糖糖加非营养性吸吮缓解新生儿疼痛的效果,为新生儿疼痛管理提供依据。方法将新生儿监护中心胎龄≥30周且喂奶量≥5ml/次、日龄≥2d的新生儿随机分为干预组和对照组,干预组新生儿在静脉穿刺及动脉采血操作前2min喂葡萄糖0.5～2ml,并给予非营养性吸吮;对照组新生儿在创伤性操作过程中不给予任何干预。观察两组新生儿动、静脉穿刺时的疼痛程度、哭闹持续时间、心率、呼吸和血氧饱和度变化。结果口服葡糖糖加非营养性吸吮组新生儿疼痛程度低,哭闹持续时间短,心率、呼吸频率及血氧饱和度变化也小于对照组,差异均有统计学意义(P0.05或0.01)。结论口服葡萄糖加非营养性吸吮可明显减轻新生儿的疼痛反应。     

Non-nutritive sucking and facilitated tucking relieve preterm infant pain during heel-stick procedures: a prospective, randomised controlled crossover trial

BackgroundPreterm infants’ repeated exposure to painful procedures may contribute to negative consequences. Thus, improving preterm infants’ neurodevelopmental outcomes requires prioritising their pain management.ObjectivesTo compare the effectiveness of two non-pharmacological pain-relief strategies (non-nutritive sucking and facilitated tucking) with routine care on preterm infants’ pain, behavioural, and physiological responses before, during, and after heel-stick procedures.DesignProspective, randomised controlled crossover trial.SettingLevel III Neonatal Intensive Care Unit in Taipei.MethodThirty-four preterm infants (gestational age 29–37 weeks) needing three procedural heel sticks were recruited by convenience sampling and randomly assigned to a sequence of three treatments (two pain-relief interventions and the control condition): (1) routine care, non-nutritive sucking, facilitated tucking, (2) non-nutritive sucking, facilitated tucking, routine care, and (3) facilitated tucking, routine care, non-nutritive sucking. Each treatment condition was performed on a different day to avoid any carry-over effect. Pain was measured by the Premature Infant Pain Profile (PIPP), infant behaviour by a behavioural coding scheme, and physiological signals by electrocardiogram monitors. All data were collected 3 min without stimuli (baseline), during heel-stick procedures, and recovery.ResultsInfants receiving non-nutritive sucking and facilitated tucking had significantly lower mean (standard deviation) pain scores during heel-stick procedures (6.39 [3.35] and 7.15 [3.88], respectively) than those receiving routine care (9.52 [4.95]). Infants receiving non-nutritive sucking and facilitated tucking had significantly lower odds ratios (0.39, p = 0.011 and 0.34, p = 0.005, respectively) for pain (PIPP score ≥ 6) than infants receiving routine care after adjusting for time, baseline pain scores, and infants’ characteristics. Similarly, infants receiving non-nutritive sucking and facilitated tucking had significantly lower odds ratios (0.23, p < 0.001 and 0.28, p = 0.03, respectively) for moderate-to-severe pain (PIPP score ≥ 12) than infants receiving routine care. Infants receiving facilitated tucking had lower frequency ratios for stress-related behaviours, abnormal heart rates, and decreased oxygen saturation than infants receiving routine care.ConclusionsBoth non-nutritive sucking and facilitated tucking effectively reduced pain scores more than routine care during heel-stick procedures. Non-nutritive sucking reduced PIPP pain scores more effectively than facilitated tucking. However, facilitated tucking showed broader effects not only on relieving pain, but also on enhancing infants’ physiological and behavioural stability during heel-stick procedures.