联合非药物干预方法对新生儿静脉穿刺疼痛的影响

发布时间：2018-01-20 11:19

本文关键词： 蔗糖溶液非营养性吸吮足月新生儿静脉穿刺疼痛　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的探索并比较蔗糖溶液联合非营养性吸吮、非营养性吸吮及蔗糖溶液对足月新生儿接受静脉穿刺时疼痛的干预效果。方法2015年6月~2016年6月便利选取青岛大学附属医院新生儿重症监护室120例接受静脉穿刺的足月新生儿,随机分为3组:蔗糖溶液联合非营养性吸吮组、非营养性吸吮组、蔗糖溶液组,每组40名新生儿。在静脉穿刺前2分钟,蔗糖溶液联合非营养性吸吮组给予2ml24%的蔗糖溶液,喂毕给予安抚奶嘴吸吮;非营养性吸吮组仅给予安抚奶嘴吸吮;蔗糖溶液组仅给予2ml24%的蔗糖溶液;非营养性吸吮干预延续至静脉穿刺完成后4分钟。采用行为指标(疼痛面容、啼哭、新生儿疼痛评估量表)和生理指标(心率、血氧饱和度)分别评估三组干预措施在减轻疼痛方面的效果。结果1.蔗糖溶液联合非营养性吸吮组静脉穿刺阶段和恢复阶段新生儿疼痛评分中位数分别为2与1,蔗糖溶液组是3与2,非营养性吸吮组是5与4,三组在两个阶段两两比较差异有统计学意义(P0.017)。蔗糖溶液联合非营养性吸吮组接受静脉穿刺后疼痛面容持续时间16秒小于蔗糖组22秒和非营养性吸吮组53秒,三组差异有统计学意义(P0.017),蔗糖溶液联合非营养性吸吮组和蔗糖溶液组静脉穿刺后啼哭的人数均为20少于非营养性吸吮组啼哭人数31人,差异有统计学意义(P0.017)。蔗糖溶液联合非营养性吸吮组和蔗糖溶液组接受静脉穿刺后啼哭持续时间分别为11秒和18秒小于非营养性吸吮组37.5秒,差异有统计学意义(P0.017)。蔗糖溶液组啼哭持续时间18秒与蔗糖溶液联合非营养性吸吮组啼哭持续时间11秒之间的差异无统计学意义(P0.05)。2.蔗糖溶液联合非营养性吸吮组静脉穿刺阶段心率均值1 2 8.3 8±1 6.4 5次/分低于蔗糖溶液组心率均值143.83±17.31次/分和非营养性吸吮组心率均值156±16.39次/分,三组差异均有统计学意义(P0.05)。蔗糖溶液联合非营养性吸吮组静脉穿刺阶段血氧饱和度均值95.66±2.12%高于蔗糖溶液组均值94.06±2.13%和非营养性吸吮组92.02±2.55%,差异均有统计学意义(P0.05)。恢复阶段2min时,蔗糖溶液联合非营养性吸吮组心率均值122.63±15.69次/分和蔗糖溶液组的心率均值132±12.40次/分低于非营养性吸吮组147.38±13.52次/分,差别有统计学义(P0.05),蔗糖溶液联合非营养性吸吮组心率与蔗糖溶液组的差别无统计学意义(P0.05)。恢复阶段2min时,蔗糖溶液联合非营养性吸吮组血氧饱和度均值9 6.4±1.9 0%和蔗糖溶液组血氧饱和度均值9 4.9±1.6 6%高于非营养性吸吮组92.8±1.32%,差异有统计学意义(P0.05),蔗糖溶液联合非营养性吸吮组血氧饱和度与蔗糖溶液组的差别无统计学意义(P0.05)。恢复阶段4min时,三组新生儿心率和血氧饱和度之间的差别无统计学意义(P0.05)。结论蔗糖溶液联合非营养性吸吮与两者单独实施相比:能够降低新生儿疼痛评分,缩短新生儿疼痛面容持续时间,降低新生儿静脉穿刺过程中和结束后的心率,提高血氧饱和度。蔗糖溶液联合非营养性吸吮缓解静脉穿刺所致疼痛的效果优于蔗糖溶液和非营养性吸吮单独实施。两者单独干预时,蔗糖溶液缓解静脉穿刺所致疼痛的效果优于非营养性吸吮。
[Abstract]:Objective to explore and compare the sucrose solution combined with non nutritive sucking, the intervention effect of non nutritive sucking and sucrose on the newborn accepted venepuncture pain. Methods from June 2015 June ~2016 convenience select Qiingdao University hospital NICU newborn 120 cases received intravenous puncture, were randomly divided into 3 groups: combined with non sucrose solution nutritive sucking group, non nutritive sucking group, sucrose solution group, each group of 40 newborns. In 2 minutes before venipuncture, sucrose solution of sucrose solution and non nutritive sucking group were given 2ml24%, given the pacifier feeding after sucking; non nutritive sucking group only received pacifier sucking; sucrose sucrose group administration of 2ml24% only 4 minutes; non nutritive sucking intervention lasted until after the completion of the vein puncture. The behavioral indicators (face pain, crying, neonatal pain assessment scale) And the physiological indexes (heart rate, blood oxygen saturation) respectively to assess the effect of the intervention of the three groups in reducing pain. Results 1. sucrose solution and non nutritive sucking group vein puncture stage and restoration stage of neonatal pain score was respectively 2 and 1, 3 and 2 sucrose solution group, non nutritive sucking group is 5 and 4, the three groups in the two stage, 22 difference was statistically significant (P0.017). The sucrose solution combined with non nutritive sucking group received intravenous puncture pain after the face for 16 seconds 22 seconds less than sucrose group and non nutritive sucking group for 53 seconds, there was significant difference between three groups (P0.017), combined with non sucrose solution nutritive sucking group and sucrose solution group after venipuncture crying there were 20 less than the non nutritive sucking group were the number 31, the difference was statistically significant (P0.017). The sucrose solution combined with non nutritive sucking group and sucrose solution The liquid group received venous puncture after crying duration were 11 seconds and 18 seconds less than non nutritive sucking group for 37.5 seconds, the difference was statistically significant (P0.017). The sucrose group crying for 18 seconds and the difference of sucrose solution combined with non nutritive sucking group crying duration between 11 seconds was not statistically significant (P0.05).2. sucrose solution combined with non nutritive sucking vein puncture group stage 128.38 + 16.45 / min. mean heart rate is lower than the sucrose solution heart rate is 143.83 + 17.31 / min and non nutritive sucking heart rate is 156 + 16.39 / min, there were significant differences between three groups (P0.05). The sucrose solution combined with non nutritive sucking group vein oxygen saturation stage average of 95.66 + 2.12% higher than the average of 94.06 + 2.13% sucrose solution group and non nutritive sucking group 92.02 + 2.55%, the differences were statistically significant (P0.05). The recovery stage of 2min, sugarcane Sugar solution and non nutritive sucking heart rate is 122.63 + 15.69 / min and sucrose solution were 132 + 12.40 / min mean heart rate is lower than the non nutritive sucking group 147.38 + 13.52 / min, the difference are statistically significant (P0.05), sucrose solution and non nutritive sucking group, heart rate and sugar solution group (no significant difference P0.05). The recovery stage of 2min, sucrose solution and non nutritive sucking group mean oxygen saturation 96.4 + 1.90% sucrose solution and group mean oxygen saturation 94.9 + 1.66% higher than that of non nutritive sucking group 92.8 + 1.32%, the difference was statistically significant (P0.05), sucrose solution and non nutritive sucking blood oxygen saturation and sucrose group difference solution: there is statistical significance (P0.05). The recovery stage of 4min, between the three groups of neonatal heart rate and oxygen saturation had no significant difference (P0.05). Conclusion: sucrose solution combined with non nutritive Suck and two separate implementation compared: can reduce neonatal pain score, reduce neonatal pain face duration, reduce the end of neonatal venous puncture during and after the heart rate, improve blood oxygen saturation. Sucrose solution combined with non sucking effect is better than that of sucrose solution and non nutritive sucking nutrition to relieve pain caused by vein puncture. Both single intervention alone when the effect of sucrose solution to alleviate the pain caused by vein puncture is better than that of non nutritive sucking.

【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.72

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