白噪音联合水合氯醛在新生儿腰穿术中的镇静效果观察  

An observation on the sedative effect of white noise combined with chloral hydrate on neonatal lumbar puncture

作　　者：尤敏仪 黄仁 康四梅 阮婉芬 YOU Min-yi;HUANG Ren;KANG Si-mei(Department of Paediatrics, Shunde Hospital, Southern Medical University(The First People′s Hospital of Shunde Foshan), Guangdong 528300, China)

机构地区：[1]南方医科大学顺德医院(佛山市顺德区第一人民医院)儿科,广东528300

出　　处：《中国临床新医学》2022年第5期399-403,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：佛山市卫生健康局医学科研项目(编号:20210026)。

摘　　要：目的观察白噪音联合水合氯醛在新生儿腰穿术中的镇静效果。方法选取2020年11月至2021年10月南方医科大学顺德医院收治的70例行腰穿术新生儿,采用随机数字表法将其分为观察组和对照组,每组35例。对照组腰穿进针前30 min予自吮奶液稀释的水合氯醛50 mg/kg,观察组在对照组基础上加用白噪音干预。比较两组腰穿成功率、腰穿进针时新生儿疼痛量表(NIPS)评分,以及干预前后不同时间点Brussels镇静评分和生命体征指标。观察两组不良反应发生情况。结果观察组腰穿时NIPS评分显著低于对照组[(3.34±1.39)分vs(4.37±2.46)分;t=2.151,P=0.036]。两组Brussels镇静评分均随时间进展呈下降趋势,观察组变化幅度更大(P<0.05)。两组血氧饱和度均随干预时间进展呈上升趋势,收缩压、心率、呼吸频率呈下降趋势(P<0.05)。观察组心率和呼吸频率下降幅度较对照组显著(P<0.05)。观察组腰穿成功率和一针穿刺成功率与对照组比较差异无统计学意义(91.43%vs 88.57%;65.71%vs 62.86%。P>0.05)。两组均未发生心动过缓、低血压、血氧饱和度下降等不良反应。结论白噪音联合水合氯醛在新生儿腰穿术中镇静、镇痛效果显著,安全性好,具有推广价值。Objective To observe the sedative effect of white noise combined with chloral hydrate on neonatal lumbar puncture.Methods Seventy neonates who were admitted to Shunde Hospital of Southern Medical University from November 2020 to October 2021 for lumbar puncture were selected and divided into an observation group and a control group by random number table method,with 35 cases in each group.The control group was given chloral hydrate 50 mg/kg diluted with self-sucking milk 30 minutes before lumbar puncture,and the observation group was intervened with white noise on the basis of the same treatment as the control group.The success rate of lumbar puncture,Neonatal Infant Pain Scale(NIPS)score during lumbar puncture needle insertion,and Brussels sedation score and vital signs at different time points before and after intervention were compared between the two groups.The occurrence of adverse reactions in the two groups was observed.Results The NIPS scores of the observation group at the time of lumbar puncture were significantly lower than those of the control group[(3.34±1.39)points vs(4.37±2.46)points;t=2.151,P=0.036].The Brussels sedation scores in both groups showed a downward trend with time,and the changes in the observation group were greater(P<0.05).The blood oxygen saturation in both groups showed an upward trend with the progress of the intervention time,while the systolic blood pressure,heart rate and respiratory rate showed a downward trend(P<0.05).The decreases of heart rate and respiratory rate in the observation group were more significant than those in the control group(P<0.05).There were no significant differences in the success rate of lumbar puncture and the success rate of one-needle puncture between the observation group and the control group(91.43%vs 88.57%,65.71%vs 62.86%;P>0.05).There were no adverse reactions such as bradycardia,hypotension and decreased blood oxygen saturation in both groups.Conclusion White noise combined with chloral hydrate has significant sedative and analgesic effects

关 键 词：白噪音 水合氯醛 新生儿 腰椎穿刺术 镇静 

分 类 号：R726[医药卫生—儿科]