白噪声联合非营养性吸吮在早产儿视网膜病筛查疼痛干预中的应用效果

刘丽萍; 王丹丹; 王红利; 高峰

doi:10.16766/j.cnki.issn.1674-4152.003379

白噪声联合非营养性吸吮在早产儿视网膜病筛查疼痛干预中的应用效果

doi: 10.16766/j.cnki.issn.1674-4152.003379

河南省人民医院新生儿重症监护室河南省护理医学重点实验室郑州大学人民医院，河南郑州 450000

基金项目:

河南省医学科技攻关计划联合共建项目 LHGJ20220041

详细信息

通讯作者:
刘丽萍，E-mail：Liuliping1236541@163.com

中图分类号: R722
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- 被引次数: 0
出版历程
- 收稿日期: 2023-01-12
- 网络出版日期: 2024-03-27

Effect of white noise combined with non-nutritive sucking in screening for pain intervention in retinopathy of prematurity

NICU, Henan Provincial People's Hospital, Henan Provincial Key Laboratory of Nursing Medicine, Zhengzhou University People's Hospital, Zhengzhou, Henan 450000, China

摘要

摘要: 目的探讨白噪声联合非营养性吸吮在早产儿视网膜病(ROP)筛查操作性疼痛干预中的应用效果。方法选取2020年2月—2021年2月在河南省人民医院新生儿重症监护病房(NICU)住院治疗的早产儿212例，根据随机数字表法分为白噪声组50例、吸吮组52例、白噪声联合吸吮组(联合组)56例以及对照组54例。4组均行眼底筛查，筛查过程中4组分别给予白噪声干预、非营养性吸吮干预、白噪声联合非营养性吸吮干预和常规体位安抚干预。应用早产儿疼痛评估量表(PIPP)评定筛查操作性疼痛程度，比较4组筛查前后的PIPP评分、血氧饱和度和心率。结果筛查后1 min和5 min，白噪声组、非营养性吸吮组、联合组PIPP评分均明显低于对照组(P＜0.001)，而联合组PIPP评分均明显低于白噪声组和非营养性吸吮组(P＜0.01)；筛查后1 min和5 min，白噪声组、非营养性吸吮组、联合组血氧饱和度明显高于对照组，心率明显低于对照组(P＜0.01)，而联合组血氧饱和度明显高于白噪声组和非营养性吸吮组，心率明显低于白噪声组和非营养性吸吮组(P＜0.01)。结论白噪声联合非营养性吸吮能明显减轻ROP筛查操作性疼痛，稳定早产儿生命体征，值得在临床推广和使用。
- 早产儿视网膜病 /
- 非营养性吸吮 /
- 白噪声 /
- 疼痛
Abstract: Objective To investigate the effect of white noise combined with non-nutritive sucking in the screening of retinopathy of prematurity (ROP). Methods A total of 212 premature infants hospitalized in neonatal intensive care unit (NICU) of Henan Provincial People's Hospital from February 2020 to February 2021 were selected and randomly divided into white noise group (50 cases), sucking group (52 cases), white noise combined sucking group (56 cases) and control group (54 cases) according to random number table method. All the 4 groups underwent fundus screening. During the screening process, the 4 groups were given white noise intervention, non-nutritional sucking intervention, white noise combined non-nutritional sucking intervention and routine postural comfort intervention, respectively. Preterm infant pain profile (PIPP) was used to assess the degree of operational pain, and PIPP score, blood oxygen saturation and heart rate before and after screening were compared in the 4 groups. Results At 1 min and 5 min after screening, PIPP scores in the white noise group, the non-nutritive sucking group and the combined group were significantly lower than those in the control group (P < 0.001), while PIPP scores in the combined group were significantly lower than those in the white noise group and the non-nutritive sucking group (P < 0.01). At 1 min and 5 min after screening, the blood oxygen saturation of the white noise group, the non-nutritive sucking group and the combined group was significantly higher than that of the control group, and the heart rate was significantly lower than that of the control group (P < 0.01), while the blood oxygen saturation of the combined group was significantly higher than that of the white noise group and the non-nutritive sucking group, and the heart rate was significantly lower than that of the white noise group and the non-nutritive sucking group (P < 0.01). Conclusion White noise combined with non-nutritive sucking can significantly reduce the pain of ROP screening operation and stabilize the vital signs of premature infants, which is worthy of clinical promotion and application.
- Retinopathy of prematurity /
- Non-nutritive sucking /
- White noise /
- Pain

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表 1 各组早产儿一般临床资料比较

Table 1. Comparison of general clinical data of premature infants in each group

组别	例数	性别(男/女，例)	胎龄(x±s，周)	筛查年龄(x±s，d)	出生体重(x±s，g)
白噪声组	50	21/29	31.61±1.85	35.79±1.87	1 697.85±165.75
非营养吸吮组	52	26/26	32.12±1.57	35.93±1.56	1 712.73±139.58
联合组	56	25/31	31.82±1.68	35.85±1.73	1 645.72±145.53
对照组	54	28/26	31.75±1.69	36.17±1.86	1 678.95±159.87
统计量		0.667^a	0.825^b	0.478^b	1.936^b
P值		0.716	0.481	0.698	0.125
注：^a为χ²值，^b为F值。

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表 2 各组早产儿眼底筛查后PIPP评分比较(x±s，分)

Table 2. Comparison of PIPP score after fundus screening in preterm infants in each group (x±s, points)

组别	例数	筛查前5 min	筛查后1 min	筛查后5 min
白噪声组	50	3.92±0.75	8.92±1.32^a	6.85±0.76^a
非营养吸吮组	52	3.87±0.73	8.87±1.35^a	6.97±0.78^a
联合组	56	3.89±0.88	7.65±1.26^abc	4.72±0.53^abc
对照组	54	3.95±0.71	13.25±1.17	8.69±0.86
F值		0.109	201.317	265.677
P值		0.955	＜0.001	＜0.001
注：F_时间=3.117，P=0.048；F_组间=4.771，P=0.031；F_交互=11.786，P＜0.001。与对照组比较，^a P＜0.01；与白噪声组比较，^b P＜0.01；与非营养性吸吮组比较，^c P＜0.01。

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表 3 各组早产儿筛查前后血氧饱和度比较(x±s，%)

Table 3. Comparison of oxygen saturation of premature infants before and after screening (x±s, %)

组别	例数	筛查前5 min	筛查后1 min	筛查后5 min
白噪声组	50	95.73±1.49	89.62±1.31^a	93.18±1.69^a
非营养吸吮组	52	96.17±1.51	89.65±1.27^a	93.25±1.78^a
联合组	56	95.82±1.59	91.87±1.36^abc	94.96±1.73^abc
对照组	54	95.96±1.71	88.21±1.19	91.79±1.85
F值		0.762	76.467	29.793
P值		0.517	＜0.001	＜0.001
注：F_时间=3.489，P=0.046；F_组间=4.320，P=0.041；F_交互=12.696，P＜0.001。与对照组比较，^a P＜0.01；与白噪声组比较，^b P＜0.01；与非营养性吸吮组比较，^c P＜0.01。

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表 4 各组早产儿筛查前后心率比较(x±s，次/min)

Table 4. Comparison of heart rate of premature infants before and after screening (x±s, times/min)

组别	例数	筛查前5 min	筛查后1 min	筛查后5 min
白噪声组	50	139.43±6.73	158.73±7.85^a	152.69±8.81^a
非营养吸吮组	52	139.78±6.83	157.82±8.75^a	151.97±8.83^a
联合组	56	138.52±7.82	152.51±9.37^abc	142.19±7.87^abc
对照组	54	138.96±7.98	163.68±8.97	157.72±8.92
F值		0.298	14.956	31.385
P值		0.827	＜0.001	＜0.001
注：F_时间=5.764，P=0.013；F_组间=5.104，P=0.026；F_交互=19.896，P＜0.001。与对照组比较，^a P＜0.01；与白噪声组比较，^b P＜0.01；与非营养性吸吮组比较，^c P＜0.01。

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参考文献(16)

[1]	陈文清, 丁璐. 早产儿视网膜病的相关影响因素及护理干预[J]. 海南医学, 2017, 28(20): 3428-3429. https://www.cnki.com.cn/Article/CJFDTOTAL-HAIN201720057.htm CHEN W Q, DING L. Related factors and nursing intervention of retinopathy of prematurity[J]. Hainan Medical Journal, 2017, 28(20): 3428-3429. https://www.cnki.com.cn/Article/CJFDTOTAL-HAIN201720057.htm
[2]	PROMELLE V, MILAZZO S. Retinopathy of prematurity[J]. J Fr Ophtalmol, 2017, 40(5): 430-437. doi: 10.1016/j.jfo.2016.12.013
[3]	黄晓霞, 莫海明, 韦美荣, 等. 母婴同室足月新生儿眼底筛查流程建立与应用[J]. 护理研究, 2017, 31(24): 3017-3019. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ201724020.htm HUANG X X, MO H M, WEI M R, et al. Establishment and application of fundus screening process of full-term neonates in mother and child room[J]. Chinese Nursing Researsh, 2017, 31(24): 3017-3019. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ201724020.htm
[4]	任向芳, 顾卓颖, 杨梅, 等. 白噪声联合非营养性吸吮减轻早产儿视网膜病筛查疼痛的效果[J]. 护理研究, 2021, 35(17): 3154-3157. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202117029.htm REN X F, GU Z Y, YANG M, et al. Effect of white noise combined with non?nutritive sucking on alleviating pain of retinopathy screening in premature infants[J]. Chinese Nursing Research, 2021, 35(17): 3154-3157. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202117029.htm
[5]	SEZICI E, YIGIT D. Comparison between swinging and playing of white noise among colicky babies: a paired randomized controlled trial[J]. J Clin Nurs, 2018, 27(3-4): 593-600. doi: 10.1111/jocn.13928
[6]	GAO H X, LI M, GAO H L, et al. The effect of non-nutritive sucking and sucrose alone and in combination for repeated procedural pain in preterm infants: a randomized controlled trial[J]. Int J Nurs Stud, 2018, 83(1): 25-33.
[7]	BASHINSKY A L. Retinopathy of prematurity[J]. N C Med J, 2017, 78(2): 124-128.
[8]	LEA C L, SMITH COLLINS A, LUYT K. Protecting the premature brain: current evidence-based strategies for minimising perinatal brain injury in preterm infants[J]. Arch Dis Child Fetal Neonatal Ed, 2017, 102(2): F176-F182. doi: 10.1136/archdischild-2016-311949
[9]	任向芳, 李婷, 孔祥永, 等. 白噪声减轻早产儿眼底筛查疼痛的效果观察[J]. 发育医学电子杂志, 2019, 7(3): 223-226. https://www.cnki.com.cn/Article/CJFDTOTAL-FYYD201903014.htm REN X F, LI T, KONG X Y, et al. Effect of white noise on relieving pain in fundus screening for premature infants[J]. Journal of Developmental Medicine (Electronic Version), 2019, 7(3): 223-226. https://www.cnki.com.cn/Article/CJFDTOTAL-FYYD201903014.htm
[10]	任向芳, 王自珍, 杨梅, 等. 白噪声联合葡萄糖减轻早产儿视网膜病筛查疼痛的临床研究[J]. 中国当代儿科杂志, 2019, 21(12): 1159-1163. https://www.cnki.com.cn/Article/CJFDTOTAL-DDKZ201912002.htm REN X F, WANG Z Z, YANG M, et al. Clinical effect of white noise combined with glucose in reducing the pain of retinopathy screening in preterm infants[J]. Chinese Journal of Contemporary Pediatrics, 2019, 21(12): 1159-1163. https://www.cnki.com.cn/Article/CJFDTOTAL-DDKZ201912002.htm
[11]	聂莉莉, 邓春贵, 何建龙, 等. 重力管饲喂养联合口腔运动对早产儿喂养不耐受的影响[J]. 中华全科医学, 2017, 15(11): 1922-1924, 1974. doi: 10.16766/j.cnki.issn.1674-4152.2017.11.030 NIE L L, DENG C G, HE J L, et al. The effect of combined treatment with gravitational tube feeding and oral motor in treatment of feeding intolerance in preterm[J]. Chinese Journal of General Practice, 2017, 15(11): 1922-1924, 1974. doi: 10.16766/j.cnki.issn.1674-4152.2017.11.030
[12]	段旭锋, 赵艳, 杨阿平, 等. 白噪声干预缓解新生儿足跟采血疼痛的效果评价[J]. 护理学杂志, 2017, 32(19): 71-72. https://www.cnki.com.cn/Article/CJFDTOTAL-HLXZ201719027.htm DUAN X F, ZHAO Y, YANG A P, et al. Effect of white noise intervention on pain degree induced by heelstick blood sampling in newborn babies[J]. Journal of Nursing Science, 2017, 32(19): 71-72. https://www.cnki.com.cn/Article/CJFDTOTAL-HLXZ201719027.htm
[13]	PINEDA R, DEWEY K, JACOBSEN A, et al. Non-nutritive sucking in the preterm infant[J]. Am J Perinatol, 2019, 36(3): 268-276. doi: 10.1055/s-0038-1667289
[14]	何婧, 刘蓓蓓, 罗敏, 等. 袋鼠式护理联合非营养性吸吮对缓解早产儿微量血糖采血疼痛的作用[J]. 四川医学, 2018, 39(4): 467-471. https://www.cnki.com.cn/Article/CJFDTOTAL-SCYX201804031.htm HE Q, LIU B B, LUO M, et al. Effect of kangaroo mother care combined with non nutritive sucking on alleviating the pain of trace blood glucose collection in premature infants[J]. Sichuan Medical Journal, 2018, 39(4): 467-471. https://www.cnki.com.cn/Article/CJFDTOTAL-SCYX201804031.htm
[15]	张晓莉. 拥抱安抚联合非营养性吸吮对头皮动脉采血新生儿啼哭时间的影响[J]. 实用中西医结合临床, 2021, 21(1): 148-150. https://www.cnki.com.cn/Article/CJFDTOTAL-SZXL202101072.htm ZHANG X L. The effect of hugging and soothing combined with non-nutritive sucking on crying time of newborn with scalp artery blood collection[J]. Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine, 2021, 21(1): 148-150. https://www.cnki.com.cn/Article/CJFDTOTAL-SZXL202101072.htm
[16]	HARDING C, COCKERILL H, CANE C, et al. Using non-nutritive sucking to support feeding development for premature infants: a commentary on approaches and current practice[J]. J Pediatr Rehabil Med, 2018, 11(3): 147-152.