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目的通过对新生儿重症监护病房(NICU)接受桡动脉穿刺的新生儿进行疼痛评分,观察其非药物干预的止痛效果。方法将接受桡动脉穿刺的新生儿按入院顺序随机分为3组:(1)对照组;(2)非营养性吸吮组(NNS组);(3)非营养性吸吮+葡萄糖组(NNS+GS组)。应用多参数心电监护仪监测各组新生儿穿刺前后经皮血氧饱和度(SpO_2)、心率和呼吸频率变化及应用新生儿疼痛评分简表(PIPP)对各组新生儿疼痛进行评分。结果各组新生儿在遭受桡动脉穿刺时的心率、呼吸频率均增快,SpO_2降低(P均<0.01),其中NNS组及NNS+GS组干预后心率、呼吸频率、SpO_2的变化较对照组小(P<0.05),且可较快恢复至穿刺前。桡动脉穿刺后行PIPP评分,NNS组、NNS+GS组明显低于对照组,差异有显著统计学意义(P<0.01)。NNS+GS组PIPP评分低于NNS组,差异有统计学意义(P<0.05)。结论 (1)心率、呼吸频率、SpO_2可作为评价新生儿疼痛的生理指标,PIPP疼痛评分简便、实用,可在临床推广应用。(2)非营养性吸吮及非营养性吸吮联合葡萄糖均能缓解新生儿疼痛,但非营养性吸吮联合葡萄糖止痛效果更好。
Objective To assess the analgesic effect of non-drug intervention on newborns receiving neonatal radial artery puncture in neonatal intensive care unit (NICU). Methods Neonates undergoing radial artery puncture were randomly divided into 3 groups according to the admission order: (1) control group; (2) non-nutritive sucking group (NNS group); (3) non-nutritive sucking + glucose group GS group). The changes of percutaneous oxygen saturation (SpO_2), heart rate and respiratory rate before and after neonatal operation were monitored by multi-parameter ECG monitor. Neonatal pain scores were scored using Neonatal Pain Index (PIPP). Results The heart rate and respiratory rate of neonates underwent radial artery puncture increased rapidly and SpO_2 decreased (all P <0.01), while the changes of heart rate, respiratory rate and SpO_2 in NNS group and NNS + GS group were more than those in control group Small (P <0.05), and can be quickly restored to the pre-puncture. The PIPP scores after radial artery puncture were significantly lower in NNS group and NNS + GS group than those in control group (P <0.01). The PIPP score of NNS + GS group was lower than that of NNS group, the difference was statistically significant (P <0.05). Conclusions (1) Heart rate, respiratory rate, SpO_2 can be used as physiological indexes to evaluate neonatal pain. PIPP pain score is simple and practical and can be widely used clinically. (2) Both non-nutritive sucking and non-nutritive sucking combined with glucose can relieve neonatal pain, but non-nutritive sucking combined with glucose has better analgesic effect.