包含母乳的多感官刺激疗法在早产儿静脉穿刺疼痛中的应用  

Application of multi-sensory stimulation with breastmilk in the venipuncture pain of premature infants

作　　者：刘佳慧 张静[2] 王京京 张瑾[3] 任娟娟 Liu Jiahui;Zhang Jing;Wang Jingjing;Zhang Jin;Ren Juanjuan(School of Nursing,Shanxi Medical University,Taiyuan 030001,China;Department of Nursing,Shanxi Children′s Hospital,Taiyuan 030013,China;Department of Neonatology,Shanxi Children′s Hospital,Taiyuan 030017,China)

机构地区：[1]山西医科大学护理学院,太原030001 [2]山西省儿童医院护理部,太原030013 [3]山西省儿童医院新生儿内科,太原030017

出　　处：《中国实用护理杂志》2024年第33期2594-2602,共9页Chinese Journal of Practical Nursing

基　　金：山西省儿童医院院内课题(2023022)。

摘　　要：目的探讨包含母乳的多感官刺激疗法在早产儿静脉穿刺疼痛中的应用效果,为临床开展新生儿疼痛管理提供理论指导。方法采用随机对照试验方法,选择2023年5—10月在山西省儿童医院住院的90例早产儿作为研究对象,采用随机数字表法分为对照组和干预组,每组45例。对照组在做好操作前准备的基础上实施新生儿常规镇痛护理措施,干预组在做好操作前准备的基础上实施包含母乳的多感官刺激疗法镇痛方案。采用修订版早产儿疼痛量表、中文版新生儿舒适量表及生理应激指标(心率及血氧饱和度)比较2组早产儿在静脉穿刺操作前3 min、操作中及操作后1~5 min的疼痛程度、舒适度水平及生理应激反应。结果最终纳入80例早产儿,干预组和对照组各40例。对照组男19例,女21例,出生胎龄为(34.61±1.16)周;干预组男22例,女18例,出生胎龄为(34.74±1.16)周。在操作中和操作后5 min,干预组修订版早产儿疼痛量表得分分别为(6.83±0.26)、(0.80±0.25)分,低于对照组的(12.25±0.70)、(2.83±0.36)分,差异均有统计学意义(Waldχ^(2)=53.31、21.43,均P<0.01);干预组中文版新生儿舒适量表得分分别为(14.15±0.64)、(6.45±0.13)分,低于对照组的(20.87±0.82)、(8.20±0.32)分,差异均有统计学意义(Waldχ^(2)=41.89、25.75,均P<0.01);干预组心率分别为(161.07±1.09)、(142.48±0.99)次/min,低于对照组的(169.30±1.93)、(147.23±2.15)次/min,差异均有统计学意义(Waldχ^(2)=13.83、4.03,均P<0.05)。在操作中至操作后2 min,干预组血氧饱和度分别为0.9503±0.0040、0.9593±0.0034、0.9663±0.0030,高于对照组的0.9253±0.0036、0.9405±0.0036、0.9500±0.0043,差异均有统计学意义(Waldχ^(2)=21.98、14.62、9.70,均P<0.05)。结论包含母乳的多感官刺激疗法可降低早产儿静脉穿刺操作中及操作后的疼痛程度,提高早产儿舒适度水平,降低早产儿生理应激反应并促进生理稳定性。Objective To explore the application effect of multi-sensory stimulation with breastmilk in preterm infants with venipuncture pain,so as to provide theoretical guidance for clinical implementation of neonatal pain management.Methods This study was a randomised controlled trial that selected 90 cases of preterm infants who were admitted to the Department of Neonatal Internal Medicine of Shanxi Children′s Hospital from May to October 2023,and were randomly divided into the control group and the intervention group,with 45 cases in each group.The control group received routine neonatal analgesia based on preparation before intervention,and the intervention group received multi-sensory stimulation with breastmilk based on preparation before intervention.Premature Infant Pain Profile-Revised(PIPP-R),The Chinese COMFORTneo Scale and physiological stress indicators(heart rate and oxygen saturation)were used to compare the pain level,comfort level and physiological stress response of preterm infants in the two groups 3 min before,during and 1 to 5 min after the venipuncture operation.Results Finally,80 cases of preterm infants were included with 40 cases in each group.The control group was born at a gestational age of(34.61±1.16)weeks,with 19 males and 21 females;the intervention group was born at a gestational age of(34.74±1.16)weeks,with 22 males and 18 females.Comparison between the groups showed that during and 5 min after the operation,the PIPP-R scale scores of the intervention group were(6.83±0.26),(0.80±0.25)points,respectively,which were lower than those of the control group(12.25±0.70),(2.83±0.36)points,and the differences were statistically significant(Waldχ^(2)=53.31,21.43,both P<0.01).The Chinese COMFORTneo Scale scores of the intervention group were(14.15±0.64),(6.45±0.13)points,which were lower than those of the control group(20.87±0.82),(8.20±0.32)points,and the differences were statistically significant(Waldχ^(2)=41.89 and 25.75,both P<0.01);the heart rate of the intervention group were(161.

关 键 词：乳 人 婴儿 早产 多感官刺激疗法 静脉穿刺 疼痛 白噪声 抚触 蜷曲体位 

分 类 号：R473.72[医药卫生—护理学]