袋鼠式护理缓解侵入性操作所致新生儿疼痛的Meta分析

The Meta Analysis of Alleviatory Effect of Kangaroo Care on Neonatal Painful Caused by Invasive Operation

目的通过对袋鼠式护理缓解侵入性操作所致新生儿疼痛的随机对照试验和(或)临床对照试验文献进行Meta分析,客观评价袋鼠式护理的效果,为临床新生儿疼痛的管理提供理论依据。方法联机检索在线PUBMED、EBSCO、OVID、EMBASE、Cochrane library、中国知网、中国生物医学文献数据库,并以手工检索和引文检索为辅助,全面获取有关袋鼠式护理缓解侵入性操作所致新生儿疼痛的中英文文献。对符合纳入标准的文献,由两名研究者独立进行方法学质量评价和资料提取。采用RevMan5.0.25统计软件进行meta分析。结果经筛选共纳入7篇临床对照试验文献。Meta分析结果显示:袋鼠式护理和襁褓包裹比较,更能稳定新生儿侵入性操作期间和操作后恢复期的心率及血氧饱和度(P<0.01),可缩短新生儿侵入性操作时和操作后恢复期啼哭和疼痛面容的持续时间(P<0.01),可减少新生儿侵入性操作时的NFCS评分(P<0.01)。结论袋鼠式护理可以有效缓解新生儿对疼痛的生理反应和行为反应,减轻新生儿疼痛。由于相关研究较少,今后尚需纳入更多设计严格的大样本随机对照试验以进一步评价袋鼠式护理缓解新生儿疼痛的效果。

Objective To evaluate the alleviatory effect of kangaroo care on neonatal pain caused by invasive operation using Meta analysis.Methods With the computer retrieval of PUBMED/MEDLINE,EBSCO,OVID,EMBASE,Cochrane library,CNKI,CMBI and auxiliary manual retrieval,citation retrieval as well,the author tried to gain the documents comprehensively in both Chinese and English on the kangaroo care easing neonatal pain caused by invasive operation.To the included documents fit for standard,two researchers were planned to screen them and then to make a methodological quality evaluation and material extraction independently.The RevMan5.0.25 statistical software for Meta analysis was used.Results After screening,seven controlled clinical trial documents were adopted,and the Meta analysis showed that the kangaroo care,in contrast with swaddling,was significantly more stable for the heart rate and blood oxygen saturation（P0.01） during the neonatal invasive operation and after operation recovery,could shorten the duration of the crying and painful facial expression during newborn invasive operation and convalescence after operation and reduce the proportion of（P0.01） the crying at the invasive nursing convalescence after operation and the duration of the existing neonatal painful facial expression,and could reduce neonatal invasive operation NFCS score（P0.01）.Conclusion kangaroo care can effectively ease the newborn physiological reaction and behavior reaction on the pain and reduce neonatal pain.More randomized controlled trials with strictly designed samples should be included,so as to further evaluate the effect of kangaroo care on neonatal pain.