母乳气味对减轻新生儿操作性疼痛效果的Meta分析

Effect of breast milk odor on relieving operational pain in neonates:a Meta-analysis

目的:系统评价母乳气味对减轻新生儿操作性疼痛的效果。方法:计算机检索PubMed、EMbase、Web of Science、the Cochrane Library、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库和维普数据库等有关母乳气味对新生儿操作性疼痛影响的随机对照试验。检索时限为各数据库建库至2022年1月。由2名评价者按照纳入、排除标准筛选文献并使用Cochrane系统评价的偏倚风险评价工具对纳入研究进行方法学质量评价;采用Stata MP 14.0软件进行Meta分析。结果:共纳入10项研究,涉及769例新生儿。Meta分析和系统评价结果显示,在疼痛评分方面,与无气味组、配方奶气味组比较,母乳气味组在致痛性操作中及操作后疼痛评分较低,差异有统计学意义(P<0.05);新生儿母乳气味组与其他母亲母乳气味组比较,致痛性操作中疼痛评分降低,差异有统计学意义(P<0.05);母乳气味组分别与羊水气味组、母亲气味组和香兰素气味组比较,致痛性操作中及操作后的疼痛评分均无明显降低,差异无统计学意义(P>0.05)。在哭闹持续时间方面,母乳气味组与无气味组比较结果尚不统一,有待进一步验证;母乳气味组与羊水气味组、母亲气味组比较,差异无统计学意义(P>0.05);熟悉气味组(母乳气味及熟悉的香兰素气味)致痛性操作后哭闹时间短于陌生气味组(不熟悉的香兰素气味或无气味),差异有统计学意义(P<0.05);致痛性操作中及操作后,母乳气味组哭闹时间短于配方奶气味组,差异有统计学意义(P<0.05)。结论:现有证据表明,母乳气味可以减轻新生儿操作性疼痛,降低操作中和操作后的疼痛程度。由于纳入研究数量有限,未来尚需开展高质量、大样本的原始研究,以进一步确认母乳气味对新生儿操作性疼痛的效果。

Objective:To systematically evaluate the effect of breast milk odor on relieving neonatal operational pain.Methods:Randomized controlled trials on the effect of breast milk odor on neonatal operational pain were retrieved from PubMed,EMbase,Web of Science,the Cochrane Library,CBM,CNKI,WanFang Database and VIP.The retrieval time was from the establishment of each database to January 2022.Two evaluators screened the literature according to the inclusion and exclusion criteria of the study and used the biased risk assessment tool of Cochrane system evaluation to evaluate the methodological quality of the included study.Stata MP 14.0 software was used for Meta-analysis.Results:A total of 10 studies were included,involving 769 neonates.The results of Meta-analysis and systematic review showed that,in terms of pain score,compared with non-odor group,formula odor group and other mother's milk odor groups,the breast milk odor group had a lower pain score during pain-causing procedures,and the difference was statistically significant(P<0.05).Compared with the non-odor group and the formula odor group,the pain score of the breast milk odor group was lower after the pain-inducing procedure,and the difference was statistically significant(P<0.05).Compared with amniotic fluid odor group,mother odor group and vanillin odor group,there was no significant decrease in pain scores during and after painful procedures in breast milk odor group(P>0.05).In terms of crying duration,the results of comparison between the breast milk odor group and the non-odor group were not uniform and needed to be further verified.There was no significant difference between breast milk odor group,amniotic fluid odor group and mother odor group(P>0.05).The crying time in the familiar odor group(breast milk odor and familiar vanillin odor)was shorter than that in the unfamiliar odor group(unfamiliar vanillin odor or no odor),and the difference was statistically significant(P<0.05).During and after painful operation,the crying time in the breast milk odor group was shorter than that in the formula milk odor group,and the difference was statistically significant(P<0.05).Conclusion:Existing evidence shows that breast milk odor can reduce operational pain in neonates and can reduce pain scores during and after operation.Due to the limited number of included studies,it is still necessary to carry out high-quality and large sample original studies in the future to further confirm the effect of breast milk odor on neonatal operational pain.