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目的:探索新生儿疼痛临床观察,诊断方法及降低疼痛应激的临床对策。方法:对254例新生儿NICU的医疗过程中操作性疼痛进行临床观察,观察其生理表现:迷走神经张力减低,植物神经系统改变;行为表现:包括面部表情(蹙眉、挤眼、鼻唇沟起皱、张口)、哭声、粗大运动及行为状态(睡眠和食欲)的改变等。对新生儿急性疼痛做出评分,得出正确的诊断,并采用综合干预的策略:非药物性干预方法或与局部的药物镇痛法联合使用,或药物镇痛。结果:254例新生儿在NICU的医疗过程中操作性疼痛得到正确的预防,诊断和治疗,对新生儿急性疼痛的再评分显示新生儿生理和行为表现明显改善。结论:NICU内的各种侵袭性操作所致新生儿疼痛,不仅造成婴儿近期的生理、行为紊乱,还将导致严重的远期后果,造成感知行为和神经功能上的损害;预防,诊断和综合干预可降低疼痛应激,有效阻断疼痛危害。
Objective: To explore the clinical observation of neonatal pain, diagnostic methods and clinical strategies to reduce pain stress. Methods: 254 cases of neonatal NICU during the medical treatment of operative pain were observed and observed its physiological manifestations: reduced vagal tone, autonomic nervous system changes; behavior: including facial expressions (frown, wink, nasolabial fold Wrinkles, mouth), crying, gross movement and behavioral changes (sleep and appetite) and so on. Score acute pain in newborns, draw a correct diagnosis, and use a combination of strategies for intervention: nonpharmacological interventions or in combination with topical analgesia, or analgesia. Results: 254 newborns were correctly prevented, diagnosed and treated with operative pain during NICU medical treatment. The re-rating of acute pain in neonates showed that the neonatal physiology and behavior improved significantly. CONCLUSION: Neonatal pain caused by various invasive procedures in the NICU not only causes the infant’s recent physical and behavioral disturbances but also leads to serious long-term consequences resulting in loss of perceived behavior and neurological function. Prevention, diagnosis and synthesis Intervention can reduce pain stress, effectively blocking the pain hazards.