袋鼠式护理联合非营养性吸吮对缓解早产儿微量血糖采血疼痛的作用

Effect of Kangaroo Mother Care Combined with Non Nutritive Sucking on Alleviating the Pain of Trace Blood Glucose Collection in Premature Infants

目的研究袋鼠式护理(Kangaroo Mother Care,KMC)配合非营养吸允(Non Nutritive Sucking,NNS)对缓解早产儿微量血糖采集所至疼痛的作用。方法选取2016年5月至2017年4月在我院新生科住院的接受微量血糖监测的早产儿100例为研究对象,按随机数字表法,随机分为观察组52例,对照组48例。观察组早产儿在袋鼠式护理开始30min后,给予持续NNS同时行微量血糖采血,采血后继续NNS 2min,袋鼠护理共持续2h;对照组早产儿按常规流程,在暖箱内接受微量血糖采血;两组早产儿统一在足后跟采血。以早产儿疼痛评分量表(PIPP)评分,评估早产儿疼痛程度。比较两组早产儿采血时PIPP评分、啼哭率;采血前、中、后的心率、血氧饱和度差异。结果 (1)接受微量血糖采血时,观察组早产儿采血开始30s心率为(148.46±5.12)次/min、血氧饱和度为(84.85±5.64)%,采血60s时心率为(158.596±4.48)次/min、血氧饱和度为(79.87±6.23)%,PIPP评分为(5.56±1.62)分,均低于对照组的采血开始30s心率(163.78±5.27)次/min、血氧饱和度(76.86±8.98)%,采血60s时心率(172.09±5.19)次/min、血氧饱和度(74.48±10.95)%,PIPP评分(10.03±1.58)分,差异均有统计学意义(P<0.01)。(2)接受微量血糖采血时,观察组啼哭发生率为50%,显著低于对照组(75%),χ~2=6.621,P<0.01,差异有统计学意义。结论袋鼠护理配合NNS,能有效缓解采集微量血糖操作导致的早产儿疼痛刺激。

Objective To study the effect of Kangaroo Mother Care（ KMC） combined with Non Nutritive Sucking（ NNS） on alleviating the pain caused by trace blood glucose collection in premature infants.Methods From May 2016 to April 2017,100 preterm infants who were hospitalized in the Department of Neonatal of our hospital and received monitoring of trace blood glucose were selected as subjects. According to the method of random digital table,they were randomly divided into observation group（ n = 52） and control group（ n = 48）. Thirty minutes after KMC,the preterm infants in the observation group were given continuous NNS and trace blood sugar extraction at the same time,after blood collection,NNS was continued for 2 minutes,and KMC lasted for 2 hours totally; The preterm infants in the control group received trace blood glucose collection in the warm box according to the routine procedure; Blood samples were both collected from the heel of preterm infants in both groups. The pain degree of preterm infants was evaluated by the pain score scale of preterm infants（ PIPP）. The PIPP score and crying rate at the time of blood collection and difference of heart rate and oxygen saturation before,during and after blood collection was compared between the two groups. Results（1）At the time of trace blood glucose collection,for premature infants in the observation group,the heart rate was（ 148. 46 ± 5. 12） times/min and the oxygen saturation was（ 84. 85 ± 5. 64） %at 30 seconds of the beginning of the blood collection,while the heart rate was（ 158. 596 ± 4. 48） times/min,the blood oxygen saturation was（ 79. 87 ± 6. 23） %,and the PIPP score was（ 5. 56 ± 1. 62） at 60 seconds,which were all lower than those of the control group at 30 seconds： the heart rate was（ 163. 78 ± 5. 27） times/min,the blood oxygen saturation was（ 76. 86 ±8. 98） % and PIPP score was（ 10. 03 ± 1. 58）,and the differences were all statistically significant（ P〈0. 01）.（2） At the time of trace blood glucose collection,the incidence of crying in the observation group was 50%,which was significantly lower than that in the control group（ χ~2= 6. 621）（ P〈0. 01）. Conclusion KMC combined with NNS can effectively relieve the pain stimulation of premature infants caused by collecting trace blood sugar.