新生儿疼痛影响因素的临床观察

Study on the influencing factors of pain in newborn infants

目的探讨新生儿疼痛的影响因素,为临床对新生儿疼痛进行干预提供依据。方法应用"新生儿急性疼痛行为评分量表"对42例新生儿进行疼痛评分,按照性别、胎龄、出生体重、穿刺类型、是否经产道分娩和生后日龄进行分组,比较各组新生儿的疼痛评分。同时应用多功能监护仪动态记录新生儿在穿刺过程中呼吸、心率、血压和经皮血氧饱和度等指标的变化。结果42例新生儿平均疼痛评分为7.6分。性别、胎龄、出生体重及穿刺类型对新生儿疼痛评分的影响无统计学意义(P值均>0.05),而是否经产道分娩和生后日龄对新生儿疼痛评分的影响有统计学意义(P值均<0.05)。在进行穿刺时,新生儿血氧饱和度下降,呼吸、心率、收缩压和舒张压均有不同程度的上升,其差异均有统计学意义(P值均<0.05)。结论新生儿疼痛在日常操作中常见,是否经产道分娩和生后日龄对新生儿疼痛程度有明显影响,新生儿疼痛时生命体征有显著变化,在临床操作中应该给予积极干预。

Objective To investigate the influencing factors of pain and the changes of vital signs in newborn infants. Methods Forty two newborn infants were rated by the behavioral scale of acute pain in newborn infants. The scores of pain were compared among infants with different gender,gestational age,birth weight,birth age,type of puncture and whether by vaginal birth or not. At the same time,the respiration rate,heart rate,blood pressure and oxygen saturation （SO2）were dynamically recorded by the multi-function monitor in the process of puncture. Results The average score of pain was 7.6. There was no significant difference among newborn infants with different gender,gestational age,birth weight and type of puncture（P〉 0.05）,while significant differences among infants with different birth age and whether by vaginal birth or not （P=0.015 and 0.043 respectively）. In the process of puncture,the SO2 was significantly decreased,while the respiration rate,heart rate,systolic and diastolic blood pressure were significantly increased. Conclusions Pain is prevalent in newborn infants and accompanied by obvious changes of vital signs. The means of childbirth and birth age have significant influence on the neonatal pain. It is suggested to pay close attention to the neonatal pain and take effective interventions.