非营养性吸吮对缓解足跟采血所致足月新生儿疼痛效果的meta分析

Efficacy of non-nutritive sucking for alleviating pain caused by heel-lance in full-term neonates: a meta-analysis

目的评价非营养性吸吮对足月新生儿接受足跟采血时的镇痛效果,为临床实践提供循证依据。方法通过计算机检索、手工检索等途径,收集国内外文献,纳入与本研究主题相关的随机对照研究(RCT)。使用Cochrane协作网系统评价手册(5.1版)推荐的偏倚风险评估工具对纳入文献进行方法学质量评价,通过RevMan 5.1软件对结局指标进行统计分析及描述。结果共纳入7个随机对照试验。Meta分析结果显示,非营养性吸吮组新生儿在足跟采血过程中的新生儿疼痛评分量表、新生儿急性疼痛评分表、新生儿面部编码系统和FLACC量表评分均低于对照组,差异有统计学意义(P均<0.05);采血过程中的血氧饱和度高于对照组;啼哭持续时间、疼痛面容持续时间均短于对照组,差异有统计学意义(P均<0.05)。心率、心率变异性、啼哭开始时间、疼痛面容出现时间与对照组相比,差异无统计学意义(P均>0.05)。结论非营养性吸吮能够有效降低足月新生儿接受足跟采血时各种疼痛量表的评分,能够较好的保持采血时新生儿的血氧饱和度,缩短啼哭持续时间和疼痛面容持续时间。

Objective To assess the efficacy of non-nutritive sucking（NNS） for alleviating pain caused by heel-lance in full-term neonates.Methods The data from relevant randomized controlled trial（RCT） were collected by electronic search and manual search.The Cochrane Handbook（5.1） was used to evaluate the methodological quality of the literature,and RevMan 5.1 software was used for meta-analysis.Results Seven RCTs that met the inclusion criteria were analyzed.The meta-analysis revealed that full-term neonates in NNS group scored lower in neonatal infant pain scale（P0.00001）,douleur aigu？ du nouveau-né（P=0.007）,neonatal facial coding system（P0.0001） and the face,leg,activity,cry and consolability pain scale（P=0.0007） during heel-lance process.SpO2 was higher than control group（P=0.02）.Duration of cry（P=0.005） and duration of pain expression（P=0.03） were shorter than control group.Other outcomes had no significant difference（P0.05）.Conclusions NNS can reduce the pain scores in full-term neonates during the heel-lance process,maintain the SpO2 better,and shorten the duration of cry as well as the duration of pain expression.