两种采血方法对减轻新生儿疼痛反应的效果

Effect of two methods of blood collection to reduce the neonatal pain

目的比较三棱针与触压式一次性末梢采血器对新生儿足跟采血时疼痛的干预效果。方法选择于2012年8月～2013年2月在江苏省无锡市妇幼保健院同一产科病区住院的60例足月新生儿作为研究对象，采用分段随机分组的方法将其分为实验组和对照组，各30例，对照组使用三棱针进行足跟采血，实验组使用触压式一次性末梢采血器进行足跟采血，比较两组新生儿在心率、血氧饱和度、面部疼痛表情持续时间及啼哭时间，使用新生儿急性疼痛行为评分量表（DNA）对新生儿的疼痛程度进行量化。结果在足跟采血过程中，实验组与对照组疼痛表情持续时间分别为（69．92±17．18）、（96．15±36．74）s，DNA评分分别为（5．58±1．56）、（6．95±1．19）分，两组比较差异均有统计学意义（t=2．32、6．34，均P＜0．05），啼哭持续时间分别为（40．58±17．74）、（59．70±32．66）s，两组差异无统计学意义（t=1．86，P＞0．05）：实验组与对照组采血穿刺时心率分别为（132．33±13．12）、（154．10±6．52）次／min，血氧饱和度分别为（92．67±3．75）％、（86．15±6．22）％，差异均有高度统计学意义（t=5．36、3．278，均P＜0．01）。结论触压式一次性末梢采血器能减少新生儿足跟采血时心率及血氧饱和度的变化，减轻新生儿足跟采血时的疼痛感；使用过程中严格执行操作流程，严防并发症的发生。

Objective To compare the pain effects caused by neonatal blood collection in heel using edged needle and contact-activated lancet. Methods A total of 60 neonates, who were born in Wuxi Maternal and Child Health-Care Hospital from August 2012 to February 2013 were divided into two groups randomly. Heel-lancing procedure were carried out in the newborns of the experiment group （n=30） and the control group （n=30） by using contact-activated lancet and edged needle respectively. Neonatal heart rate, oxygen saturation, duration of facial-pain expression and crying time were measured during the procedure and the degree of pain in the newborn were qualified using the newborn acute pain behavior rating scale （DNA）. Then the degree of pain were compared between the two groups. Results During heel blood collection process, expression of pain duration were （69.92±17.18）, （96.15±36.74） s, and DNA scores were （5.58±1.56）, （6.95±1.19） scores, in the experiment group and the control group respectively. There was statistically significant differences between the two groups （t=2.32, 6.34, P 〈0.05）. Crying duration were （40.58±17.74）, （59.70±32.66） s respectively, with no statistically significant differences （t=1.86, P 〉0.05）. There were also statistically significant differences in heart rate of （132.33＋13.12）, （154.10±6.52） times/min, and blood oxygen saturation of （92.67±3.75） %,（86.15±6.22）%, between the experiment group and the control center group （t = 5.36, 3.278, P 〈0.01）. Conclusion Compared to the edged needle method, the contact-activated lancet method can relieve pain in the newborns, reduce their heart rate and blood oxygen saturation changes during the heel-lancing procedure.