亲母母乳气味缓解新生儿操作性疼痛效果的Meta分析

Effects of mother's breast milk odor on alleviating operational pain in newborns:a Meta-analysis

目的评价亲母母乳气味缓解新生儿操作性疼痛的效果。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、CINAHL、中国知网、万方数据库中关于亲母母乳气味在新生儿操作性疼痛中应用效果的随机对照试验。检索时限为建库至2022年12月12日。由2名评价人员按照研究的纳入和排除标准独立筛选文献、提取资料,并使用Cochrane协作网手册的偏倚风险评价工具对纳入研究进行方法学质量评价。使用R 4.1.0统计软件进行Meta分析。结果共纳入18篇文献,包括1 424例新生儿。Meta分析结果显示,与对照组相比,亲母母乳气味组新生儿致痛性操作过程期间疼痛程度降低,心率降低,血氧饱和度提高,差异有统计学意义(P<0.05),哭闹时间比较差异无统计学意义(P>0.05)。与对照组相比,亲母母乳气味组新生儿致痛性操作后恢复期疼痛程度降低,心率降低,血氧饱和度提高,唾液皮质醇水平降低,差异有统计学意义(P<0.05)。结论亲母母乳气味可减轻新生儿操作性疼痛,降低心率和唾液皮质醇水平,提高新生儿的血氧饱和度。但纳入研究的样本量较少,且各研究干预时长和方式也存在差异,仍需要开展设计严谨、大样本的研究进行验证。

Objective To evaluate the effectiveness of mother's breast milk odor on alleviating operational pain in newborns.Methods The randomized controlled trial on the effect of mother's breast milk odor in operational pain of newborns was searched through computers in PubMed,Embase,Cochrane Library,Web of Science,CINAHL,China National Knowledge Infrastructure(CNKI)and Wanfang Data.The search period was from database establishment to December 12,2022.Two evaluators independently selected literature and extracted data based on the inclusion and exclusion criteria,and used the risk of bias of Cochrane Collaboration handbook to conduct methodological quality evaluations of the included study.R 4.1.0 statistical software was used for meta-analysis.Results A total of 18 articles were included,including 1424 newborns.The Meta-analysis results showed that compared with the control group,the mother's breast milk odor group showed a decrease in the degree of pain,a decrease in heart rate,and an increase in blood oxygen saturation during the painful procedure in newborns,with statistically significant differences(P<0.05).There was no statistically significant difference in crying time(P>0.05).Compared with the control group,the mother's breast milk odor group showed a statistically significant decrease in the degree of pain and heart rate,an increase in blood oxygen saturation,and a decrease in salivary cortisol in newborns during the recovery period after painful procedures(P<0.05).Conclusions The mother's breast milk odor can alleviate operational pain in newborns,reduce heart rate and salivary cortisol,and increase blood oxygen saturation in newborns.The sample size included in the study is small,and there are also differences in the duration and methods of intervention among different studies.There is still a need for rigorous design and large-scale research to verify.