口服母乳和蔗糖对缓解早产儿视网膜病变检查疼痛的效果比较

Comparison of oral breast milk and sucrose in relieving pain during screening of retinopathy of prematurity

目的比较口服母乳和蔗糖对缓解早产儿视网膜病变(retinopathy of prematurity, ROP)检查疼痛的效果。方法新生儿重症监护室早产婴儿129例,随机分为对照组、蔗糖组和母乳组,每组43例。ROP检查前2 min,对照组、蔗糖组、母乳组分别口服蒸馏水、33%蔗糖、母乳1 mL。记录所有受检婴儿ROP检查前后5 min和检查时的心率、氧饱和度、CRIES(crying, requires O_2 for SaO_2 <95%,increased vital signs, expression and sleepless)量表评分和早产儿疼痛量表(premature infant pain profile, PIPP)评分。结果 ROP检查时蔗糖组和母乳组婴儿的心率均显著低于对照组,且母乳组更低(P<0.05),而氧饱和度则两组均高于对照组(P<0.01)。ROP检查后蔗糖组与对照组的心率比较差异无统计学意义(P>0.05),而母乳组则显著低于对照组和蔗糖组(P<0.05);蔗糖组和母乳组婴儿的氧饱和度亦显著高于对照组(P<0.01),而蔗糖组和母乳组则差异无统计学意义(P>0.05)。蔗糖组、母乳组婴儿ROP检查时和检查后的CRIES、PIPP评分均显著低于对照组(P<0.05或0.01),且母乳组评分更低(P<0.05或0.01)。结论口服母乳较蔗糖更能缓解早产儿ROP检查时的疼痛。

Objective To compare oral breast milk and sucrose in relieving pain during screening of retinopathy of prematurity (ROP).Methods 129 premature infants were randomly divided into the Control Group,Sucrose Group and Breast Milk Group,43 cases in each group.2 min before the ROP screening,the premature infants in the Control Group, Sucrose Group and Breast Milk Group received 1 mL distilled water,1 mL of 33% sucrose and 1mL breast milk,respectively. The heart rate,oxygen saturation,CRIES (crying,requires O2 for SaO2 < 95%,increased vital signs,expression and sleepless) score and PIPP (premature infant pain profile) score of all the screened babies 5 min before,during and 5 min after screening of ROP were recorded.Results During the ROP screening,the Sucrose Group and Breast Milk Group had the heart rate significantly lower than the Control Group,and the Breast Milk Group showed a more significant decrease (P<0.05),and the Sucrose Group and Breast Milk Group had the oxygen saturation significantly higher than the Control Group (P<0.01).After the ROP screening,there was no statistical difference in the heart rate between the Sucrose Group and Control Group after the ROP screening (P>0.05),but the Breast Milk Group had the heart rate significantly lower than the Sucrose Group and the Control Group (P<0.05);the Sucrose Group and Breast Milk Group had the oxygen saturation significantly higher than the Control Group (P<0.01),but there was no statistical difference in the oxygen saturation between the Sucrose Group and the Control Group (P>0.05).During and after the ROP screening,the Sucrose Group and Breast Milk Group had the CRIES score and PIPP score significantly lower than the Control Group (P<0.05 or 0.01),and the Breast Milk Group showed an even lower score (P<0.05 or 0.01).Conclusion Oral breast milk is better than oral sucrose in relieving pain during the ROP screening, which is worth clinical promotion.