两种护理干预方式在早产儿桡动脉采血中的应用

The application of Two types of nursing intervention in the premature radial artery blood sampling

目的:探讨非营养性吸吮、糖水吸吮两种非药物干预缓解早产儿桡动脉采血所致疼痛的效果。方法:2013年11月至2015年3月收住石河子大学医学院第一附属医院新生儿病房的早产儿共约120例,随机分为非营养性吸吮(NNS)组、糖水组和对照组3组,每组各40例。在对早产儿进行桡动脉采血时,对照组早产儿采血前不采取任何护理干预;NNS组在开始采血之前给予及操作完毕后两分钟消过毒的无孔安慰奶嘴吸吮;糖水组在开始采血之前至操作完毕后两分钟给予25%葡萄糖5-10m L吸吮。比较3组早产儿操作前的Apgar评分、早产儿行为状态评分、操作时哭泣的时长、回复基线时长、新生儿面部编码系统(NFCS)评分和新生儿急性疼痛行为评分量表(DAN)评分。结果:在进行桡动脉穿刺采血前,3组早产儿Apgar评分、早产儿行为状态评分均无差别(>0.05);NNS组和糖水组早产儿操作时哭泣的时长、心率回复基线时长均短于对照组(<0.05);NNS组和糖水组新生儿面部编码系统的N、F、C、S、早产儿急性疼痛行为评分均低于对照组(<0.05或<0.01);NNS组和糖水组两组比较,差异无统计学意义(>0.05)。结论:早产儿在进行桡动脉穿刺时,给予非营养性吸吮或糖水吸吮可以缩短操作时哭泣的时长、心率回复基线时长,减轻其疼痛反应。

Objective： Iscussion of nonnutritive sucking and sugar water sucking to ease the pain caused by premature radial artery blood sampling.Methods：One hundred and twenty neonates dmitted to our hospital from November 2013 to March 2015 were enrolled.They were randomly divided into non-nutritive sucking （NNS） group, sugar water group and control group with 40 cases each.The control group had no any nude intervention; NNS group taked sterile nonporous pacifier sucking and sugar water group used 5-10mL sugar water sucking that containing 25% glucose before blood samples.The Apgar score, behavioral states before operation and the length of time of cry and the time of return to baseline of heart rate and newborn facial coding system （NFCS） score, neonatal acute pain behavior rating scale （DAN） score of the three groups were analyzed.Results：The Apgar score, behavioral states in these three groups had no difference （P〉O.OS）;The length of time of cry and return to baseline of heart rate of NNS group and sugar water group was shorter than control group significantly （P〈O.05）; The score of NFCS and DAN of NNS group and sugar water group were less than control group （P〈0.05 or P〈0.01）; There were no differences between NNS group and sugar water group （P〉0.O5）.Conclusion：Non nutritional sucking or sugar water sucking would shorten the time of cry and the time of return to baseline of heart rate and relieve pain when taking radial artery puncture in premature infants.