袋鼠式护理减轻新生儿足跟采血疼痛的效果观察

Effect of Kangaroo care on diminishing neonatal pain during heel lancing

目的探讨袋鼠式护理在减轻新生儿足跟采血疼痛的效果。方法将行足跟采血的60例新生儿随机分为干预组与对照组,每组各30例,干预组从足跟采血前20min至足跟采血结束后1min实施袋鼠式护理,对照组按常规护理。比较从足跟采血前10s至足跟采血结束后10s8个时间点两组新生儿心率、血氧饱和度、面部疼痛表情、啼哭持续时间和新生儿急性疼痛行为评分量表(douleur aigue nouveaune,DAN)评分情况。结果足跟采血后7个时间点新生儿心率重复测量资料分析结果:时间与主效应的交互效应比较,P<0.01,说明两组新生儿不同时间点心率是不相等的;时间效应比较,P<0.01,说明随着时间的延长,两组新生儿心率具有加快的趋势;两组新生儿穿刺后7个时间点心率比较,差异具有统计学意义(均P<0.05),干预组新生儿心率变化幅度较少。足跟采血后7个时间点两组新生儿血氧饱和度重复测量资料分析结果:时间与主效应的交互效应比较,P<0.05,说明两组新生儿不同时间点血氧饱和度是不相等的;时间效应比较,P<0.05,说明随着时间的延长,两组新生儿血氧饱和度具有降低的趋势;两组新生儿穿刺时30s、40s、50s及穿刺后血氧饱和度比较,差异具有统计学意义(均P<0.05),干预组新生儿血氧饱和度变化幅度较少。干预组新生儿啼哭持续时间明显短于对照组,DAN评分明显低于对照组(均P<0.05)。结论足跟采血可引起新生儿中重度疼痛,袋鼠式护理可有效缓解足跟采血时新生儿的疼痛程度。

Objective To investigate the effect of Kangaroo care（KC）on diminishing neonatal pain during heel lancing. Methods Sixty neonates were divided randomly into two equal groups： intervention group and control group,which 30 cases in each group.In the intervention group,neonates were treated with KC（neonates were put in direct and continuous skin-to-skin contact with his/her mom）from 20 mins before heel lancing to 1 mins after the end of the lancing.In the control group,neonates were treated with regular care.The differences in heart rate,blood oxygen saturation,facial pain expression,crying duration and DAN（Douleur Aigue Nouveaune）scores between two groups were compared at 7 time points from 10s before the heel lancing to 10s after the lancing. Results The results of repeated measu te at 7 time points after heel lancing.There were significant interaction effect between time and main effect（ P0.01）,which showed that the heart rate of two groups were not equal at different time points.Compared with the time effects（ P0.01）which showed that two groups of neonatal heart rate of the two groups would accelerate with time extension. There were significant differences（all P0.05）in heart rate at 7 time points between two groups and smaller heart rate varied range in intervention group.The results of repeated measures analysis for neonatal blood oxygen saturation at 7 time points after heel lancing. There were significant interaction effect between time and main effects（ P0.01）,which showed that the blood oxygen saturation of two groups were not equal at different time points.Compared with the time effect（ P0.01）,which showed that two groups of neonatal blood oxygen saturation would reduce with time extension.There were significant differences（all P0.05）in blood oxygen saturation of two groups at 30s,40s and 50s after heel lancing and smaller blood oxygen saturation varied range in intervention group.The crying duration and DAN scores in intervention group were significantly reduced compared with the controls（all P0.05）.Conclusions Heel lancing could lead to moderate to severe pain of neonates.KC could effectively diminish the neonatal pain degree caused by heel lancing.