母乳嗅刺激对足月新生儿足跟采血疼痛的影响

Effects of breast milk odor stimulation on the pain of heel sampling in full-term newborns

目的探讨母乳嗅刺激对新生儿足跟采血时急性疼痛的影响。方法选择2019年2月-10月在西南医科大学附属医院出生的84例足月健康新生儿。随机分为母乳组(n=42)和配方奶组(n=42)。足底采血前3min,母乳组将滴有母乳的棉球放置在距离新生儿鼻子10cm处,采血结束10min后,取走棉球。配方奶组使用配制好的配方奶液,其余操作与母乳组相同。评估两组新生儿采血前、采血中和采血后疼痛评估量表(NIPS),比较两组新生儿心率、血氧饱和度和采血前后取新生儿唾液检测皮质醇水平。结果两组新生儿采血前NIPS评分、心率和血氧饱和度差异无统计学意义(P>0.05)。采血时和采血后,两组新生儿NIPS评分、心率和血氧饱和度差异均有统计学意义(P<0.05)。与配方奶组比较,母乳组新生儿哭闹时间缩短,差异有统计学意义(P<0.05)。两组新生儿采血前唾液皮质醇水平差异无统计学意义(P>0.05)。采血后,两组新生儿唾液皮质醇水平差异均有统计学意义(P<0.05)。结论母乳嗅刺激可以有效减轻新生儿足跟采血时的疼痛,减少哭闹时间,降低唾液皮质醇的水平,是一种安全的镇痛方法。

Objective To investigate the effect of breast milk odor stimulation on the acute pain of neonates during heel acupuncture.Methods From february to october 2019,84 healthy newborns born at term in the affiliated hospital of southwest medical university hospital were included.the patients were randomly divided into breast milk group(n=42)and formula group(n=42).3 minutes before the foot blood collection,place the cotton ball dripping with breast milk 10 cm away from the newborn’s nose.The formula group used the prepared formula milk,and the rest of the procedures were the same as the breast milk group.After 10 minutes of sampling,remove the cotton ball dripping with milk/formula milk.Before,during and after blood collection,neonatal pain assessment scale(NIPS)was assessed and heart rate and blood oxygen saturation were recorded.Newborn saliva was taken before and after blood collection to measure cortisol levels.Results There was no significant difference in NIPS score,heart rate and oxygen saturation before blood collection between the two groups(P>0.05).During and after blood collection,NIPS score,heart rate and oxygen saturation of newborns in the two groups were statistically significant(P<0.05).Compared with the formula group,the crying time of newborns in the breast milk group was shortened,and the difference was statistically significant(P<0.05).There was no significant difference in salivary cortisol levels between the two groups before blood collection(P>0.05).After blood collection,there were statistically significant differences in salivary cortisol levels between the two groups(P<0.05).Conclusion Breast milk odor stimulation can effectively reduce the pain of neonatal heel blood collection,reduce the time of crying,and reduce the level of saliva cortisol,which is a safe analgesic method.