音乐联合母亲声音对先天性消化道畸形患儿PICC穿刺疼痛的缓解作用  

Effect of music in combination with maternal voice on the pain of malformation alimentary tract infants undergoing placement procedures of peripherally inserted central venous catheter

作　　者：徐晓丽[1] 印真香 胡莎[1] 赵珍珍[1] 黄莉萍[1] Xu Xiaoli;Yin Zhenxiang;Hu Sha;Zhao Zhenzhen;Huang Liping(Department of Fetal and Neonatal Surgery,Hunan Children′s Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院胎儿与新生儿外科,长沙410007

出　　处：《中国实用护理杂志》2019年第33期2588-2593,共6页Chinese Journal of Practical Nursing

摘　　要：目的探讨音乐联合母亲声音在先天性消化道畸形患儿PICC穿刺中应用的价值.方法选取2018年1-12月湖南省儿童医院胎儿与新生儿外科术后拟行PICC的60例先天性消化道畸形患儿,按照随机数字表法分为干预组和对照组各30例.对照组采用常规护理模式,干预组在穿刺时实施音乐联合母亲声音干预.比较2组患儿穿刺过程中心率、呼吸、血压、血氧饱和度(SpO2)和血浆皮质醇变化水平,采用新生儿疼痛评估量表(NIPS)评价患儿疼痛程度.结果2组患儿穿刺前心率、呼吸频率、收缩压、SpO2、新生儿疼痛评估量表(NIPS)评分比较差异无统计学意义(P>0.05);干预组穿刺时、穿刺后心率[(144.43±15.93)、(142.43±20.42)次/min]、呼吸频率[(44.70±4.51)、(43.50±4.12)]次/min、收缩压[(87.40±8.53)、(86.10±4.60)mmHg(1 mmHg=0.133 kPa)]、NIPS评分[(5.34±0.71)、(5.19±0.87)分],明显低于同时段对照组[(160.97±39.35)次/min、(159.17±31.87)次/min,(53.13±7.85)次/min、(50.47±7.70)次/min,(97.60±9.82)mmHg、(94.27±7.23)mmHg,(6.17±0.54)分、(6.15±0.66)分],干预组穿刺时SpO2明显高于对照组[(96.15±9.82)%vs(88.34±9.53)%],2组比较差异有统计学意义(t=2.134~6.682,P<0.05或0.01).2组患儿穿刺前血浆皮质醇浓度比较差异无统计学意义(P>0.05);干预组血浆皮质醇浓度穿刺5 min时为(208.91±21.07)ng/ml,穿刺结束时为(197.70±16.34)ng/ml,明显低于同时段对照组的[(246.71±35.15)、(230.95±21.81)]ng/ml,差异有统计学意义(t=5.050、6.682,P<0.01).干预组穿刺时间为(15.62±3.30)min,对照组为(24.63±4.26)min,二者比较差异有统计学意义(t=9.160,P<0.01).结论音乐联合母亲声音可以降低先天性消化道畸形患儿PICC置管时应激水平,缓解穿刺疼痛和缩短穿刺时间,是一种有效的非药物疼痛管理方法.Objective To investigate the application of music intervention in combination with maternal voice during PICC placement procedures in malformation alimentary tract infants.Methods A total of 60 malformation alimentary tract infants were enrolled in the present study in Hunan Children Hospital from January to December 2018,infants were randomly assigned to the intervention group(n=30)and the control group(n=30).Patients in the control group received conventional nursing,the intervention group received music and maternal voice intervention method.The level changes of heart rate,respiratory rate,blood pressure,blood oxygen saturation and cortisol concentration were compared between two groups,meanwhile,the pain rating were assessed by Neonatal Infant Pain Scale(NIPS).Results Before procedure,no significant difference was found between the control and intervention group in heart rate,respiratory rate,systolic pressure,SpO2 and NIPS score(P>0.05).During and after the procedure,the mean heart rate[(144.43±15.93),(142.43±20.42)times/min],respiratory rate[(44.70±4.51)and(43.50±4.12)times/min],systolic pressure[(87.40±8.53)and(86.10±4.60)mmHg]and NIPS score(5.34±0.71 and 5.19±0.87)of the intervention group was statistically lower compared to the control group[(160.97±39.35)and(159.17±31.87)times/min,(53.13±7.85)and(50.47±7.70)times/min,(97.60±9.82)and(94.27±7.23)mmHg,6.17±0.54 and 6.15±0.66;during procedure,the mean SpO2 was statistically significantly higher,compared to the control group[(96.15±9.82)%versus(88.34±9.53)%].The difference was statistically significantly(t=2.134-6.682,P<0.05).Before placement,the concentration of cortisol between the two groups showed no significant difference(P>0.05),and(208.91±21.07)ng/ml 5min after placement and(197.70±16.34)ng/ml immediately after placement,the cortisol concentration was statistically significantly lower,compared to the control group[(246.71±35.15),(230.95±21.81)ng/ml](t=5.050-6.682,P<0.05).Compared with the control group,the time needed for PICC pl

关 键 词：音乐疗法 母亲声音 先天性消化道畸形 外周静脉穿刺中心静脉置管 

分 类 号：R47[医药卫生—护理学]