新生儿重症监护病房患儿操作性疼痛现状调查

目的了解新生儿重症监护病房(NICU)患儿操作性疼痛的发生现状,以期为新生儿疼痛管理提供基础数据和临床参考。方法采用便利抽样法,选取NICU收治的新生儿120例为研究对象,应用自行设计的患儿一般情况和疾病情况调查表、患儿操作性疼痛发生状况调查表,以床旁观察的方法,记录住院期间因诊断、治疗、护理需要而接受的致痛性操作情况,应用中文版新生儿疼痛量表对患儿致痛性操作疼痛程度进行评分。结果120例患儿住院期间经历致痛性操作共8200例次,患儿致痛性操作次数的中位数为20(7,58)次,每天的中位数为5(2,10)次。呼吸系统相关操作次数最多,共发生3170例次(38.7%);辅助检查发生频次最少,共发生20例次(0.2%)。所列23项操作均能引起患儿疼痛,82.6%(19项)的操作甚至能引起患儿重度疼痛。眼科检查、PICC穿刺2项操作疼痛得分最高(7.0分),静脉注射操作得分最低(2.5±1.5分)。结论NICU患儿住院期间经历的致痛性操作频次多、疼痛程度高,亟需临床医护人员重视并采取有效干预措施降低患儿疼痛程度。

Study of neonatal procedural pain in NICU

Objective To describe the occurrence of neonatal procedural pain in NICU,and to provide basic data and references for neonatal pain management.Methods Totally,a convenient sample of 120 neonates admitted to NICU were recruited.A demographic and disease information questionnaire and an occurrence of procedural pain questionnaire were designed and relevant data were collected.A designated researcher observed at bedside the occurrence of neonatal procedural pain which were resulted by diagnostic,therapeutic,and nursing procedures.The intensity of pain was measured by using the Neonatal Infant Pain Scale(NIPS).Results The neonates experienced a total of 8 200 painful procedures.The neonates were exposed to a median of 20(interquartile rage:7,58)painful procedures per baby during hospitalization and a median of 5(2,10)painful procedures per baby per day.Respiratory system-related procedures were performed the most frequently(3 170 counts,38.7%),and auxiliary diagnostic examinations were performed the least frequently(20 counts,0.2%).All the 23 procedures listed in the questionnaire were painful,and 82.6%(19/23)of the procedures caused severe pain or more.Retinopathy of prematurity(ROP)screening and peripherally inserted central catheter(PICC)were the most painful procedures(pain score:7.0),and venous injection was the least painful procedure(pain score:2.5±1.5).Conclusion Painful procedures with high pain intensity were performed frequently in NICU neonates,which is in need of medical workers' attention.Measures should be taken to alleviate neonatal procedural pain.