早产儿静脉穿刺采用非营养性吸吮结合蔗糖溶液对患儿疼痛反应的影响

林玲; 吴龙艳

doi:10.16766/j.cnki.issn.1674-4152.003529

早产儿静脉穿刺采用非营养性吸吮结合蔗糖溶液对患儿疼痛反应的影响

doi: 10.16766/j.cnki.issn.1674-4152.003529

林玲,
吴龙艳^,

南京市儿童医院新生儿医疗中心, 江苏南京 210000

基金项目:

江苏省青年医学重点人才培养项目 QNRC2019431

详细信息

通讯作者:
吴龙艳，E-mail：874435774@qq.com

中图分类号: R473.72 R722.6
计量
- 文章访问数: 120
- HTML全文浏览量: 63
- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2023-11-01
- 网络出版日期: 2024-07-20

Effect of sucrose solution combined with non nutritive sucking on pain response of premature infants undergoing venipuncture

LIN Ling,
WU Longyan^,

Newborn Medical Center, Nanjing Children' s Hospital, Nanjing, Jiangsu 210000, China

摘要

摘要: 目的探讨非营养性吸吮结合蔗糖溶液对缓解早产儿静脉穿刺疼痛反应的效果，为改善早产儿临床护理提供便捷、有效的镇痛策略。方法选择2021年10月—2022年10月于南京市儿童医院新生儿科住院的早产儿114例，采用随机数字表法分为研究组(57例)及对照组(57例)。2组均行静脉穿刺采血，对照组穿刺前实施非营养性吸吮干预，研究组在此基础上结合蔗糖溶液干预。比较2组穿刺前后疼痛程度、心率、血氧饱和度、唾液儿茶酚胺浓度及唾液皮质醇浓度。结果研究组穿刺时疼痛程度评分为(5.67±1.02)分，低于对照组[(9.73±1.28)分, P＜0.05]；研究组穿刺时、穿刺后5 min心率分别为(150.74±5.16)次/min、(145.17±7.29)次/min，均低于对照组[(165.09±5.33)次/min、(160.75±9.36)次/min, P＜0.05]；研究组穿刺时、穿刺后5 min血氧饱和度分别为(94.40±0.23)%、(94.48±0.37)%, 均高于对照组[(94.02±0.44)%、(94.16±0.25)%，P＜0.05]；2组穿刺时、穿刺后5 min、穿刺后20 min唾液儿茶酚胺浓度及唾液皮质醇浓度比较差异均无统计学意义(P＞0.05)。结论蔗糖溶液结合非营养性吸吮可有效减轻早产儿静脉穿刺疼痛反应，稳定患儿生命体征。
- 蔗糖溶液 /
- 非营养性吸吮 /
- 早产儿 /
- 静脉穿刺 /
- 疼痛反应
Abstract: Objective To explore the effect of non nutritive sucking combined with sucrose solution on alleviating pain response during venous puncture in premature infants, providing a convenient and effective analgesic strategy for improving clinical care of premature infants. Methods A total of 114 premature infants admitted to the neonatal department of Children' s Hospital of Nanjing Medical University from October 2021 to October 2022 were selected and randomly divided into two groups using a random number table method, with 57 cases in each group. Both groups were subjected to venous puncture for blood collection, while the control group was subjected to non nutritive sucking intervention before puncture, and the study group was combined with sucrose solution intervention on this basis. The changes in pain degree, heart rate, blood oxygen saturation, salivary catecholamine concentration and salivary cortisol concentration before and after puncture were compared between the two groups. Results The pain score during puncture in the study group was (5.67±1.02) points, which was lower than that of the control group [(9.73±1.28) points, P<0.05]. The heart rates of the study group during puncture and 5 minutes after puncture were (150.74±5.16) beats/min and (145.17±7.29) beats/min, respectively, which were lower than those of the control group [(165.09±5.33) beats/min and (160.75±9.36) beats/min, P<0.05]. The blood oxygen saturation during puncture and 5 minutes after puncture in the study group were (94.40±0.23)% and (94.48±0.37)%, respectively, which were higher than those in the control group [(94.02±0.44)% and (94.16±0.25)%, P<0.05]. There was no statistically significant difference in the concentration of salivary catecholamines or salivary cortisol between the study group and the control group at the time of puncture, 5 minutes after puncture, and 20 minutes after puncture (P>0.05). Conclusion Sucrose solution combined with non nutritive sucking effectively alleviate the pain response to venous puncture in premature infants and stabilize the vital signs.
- Sucrose solution /
- Non nutritive sucking /
- Premature infant /
- Venipuncture /
- Pain response

HTML全文

表 1 2组早产儿穿刺前后疼痛程度比较(x±s，分)

Table 1. Comparison of pain levels in two groups of premature infants before and after puncture (x±s, points)

组别	例数	穿刺前20 min	穿刺时	穿刺后5 min	F值	P值
对照组	57	2.47±0.41	9.73±1.28^a	4.48±0.74^ab	1 020.700	＜0.001
研究组	57	2.51±0.45	5.67±1.02^a	4.26±0.71^ab	251.756	＜0.001
F值		0.496	18.728	1.620
P值		0.621	＜0.001	0.108
注：与同组穿刺前20 min比较，^aP＜0.05；与同组穿刺时比较，^bP＜0.05。

下载: 导出CSV

表 2 2组早产儿穿刺前后心率比较(x±s，次/min)

Table 2. Comparison of heart rates in two groups of premature infants before and after puncture (x±s, times/min)

组别	例数	穿刺前20 min	穿刺时	穿刺后5 min	穿刺后20 min	F值	P值
对照组	57	126.72±6.13	165.09±5.33^a	160.75±9.36^ab	127.29±6.35^bc	509.285	＜0.001
研究组	57	126.81±6.21	150.74±5.16^a	145.17±7.29^ab	127.61±6.62^bc	209.118	＜0.001
F值		0.078	14.604	9.915	0.263
P值		0.938	＜0.001	＜0.001	0.793
注：与同组穿刺前20 min比较，^aP＜0.05；与同组穿刺时比较，^bP＜0.05；与同组穿刺后5 min比较，^cP＜0.05。

下载: 导出CSV

表 3 2组早产儿穿刺前后血氧饱和度比较(x±s，%)

Table 3. Comparison of blood oxygen saturation before and after puncture in two groups of preterm infants (x±s, %)

组别	例数	穿刺前20 min	穿刺时	穿刺后5 min	穿刺后20 min	F值	P值
对照组	57	94.72±1.01	94.02±0.44^a	94.16±0.25^ab	94.80±0.51^bc	213.338	＜0.001
研究组	57	94.85±1.05	94.40±0.23^a	94.48±0.37^ab	94.61±0.44^b	91.702	＜0.001
F值		0.564	4.841	4.532	0.764
P值		0.574	＜0.001	＜0.001	0.447
注：与同组穿刺前20 min比较，^aP＜0.05；与同组穿刺时比较，^bP＜0.05；与同组穿刺后5 min比较，^cP＜0.05。

下载: 导出CSV

表 4 2组早产儿穿刺前后唾液儿茶酚胺浓度比较(x±s，ng/mL)

Table 4. Comparison of salivary catecholamine levels before and after puncture in two groups of premature infants (x±s, ng/mL)

组别	例数	穿刺前20 min	穿刺时	穿刺后5 min	穿刺后20 min	F值	P值
对照组	57	215.27±35.29	229.38±57.09	219.79±60.38	223.06±52.29	2.650	0.050
研究组	57	210.68±38.09	221.76±55.98	217.73±64.27	217.78±49.65	0.433	0.729
F值		0.263	1.664	0.176	0.553
P值		0.793	0.099	0.860	0.582

下载: 导出CSV

表 5 2组早产儿穿刺前后唾液皮质醇浓度比较(x±s，pg/mL)

Table 5. Comparison of salivary cortisol levels in two groups of preterm infants before and after puncture (x±s, pg/mL)

组别	例数	穿刺前20 min	穿刺时	穿刺后5 min	穿刺后20 min	F值	P值
对照组	57	1 137.94±295.07	1 218.09±336.04	1 229.96±305.77	1 184.74±229.06	1.513	0.212
研究组	57	1 221.82±328.39	1 295.27±350.03	1 288.74±296.09	1 237.06±280.73	0.776	0.509
F值		1.434	1.201	0.688	1.090
P值		0.154	0.232	0.493	0.278

下载: 导出CSV

参考文献(20)

[1]	SEN E, MANAV G. Effect of kangaroo care and oral sucrose on pain in premature infants: a randomized controlled trial[J]. Pain Manag Nurs, 2020, 21(6): 556-564. doi: 10.1016/j.pmn.2020.05.003
[2]	BUENO M, MORENO-RAMOS M C, FORNI E, et al. Adaptation and initial validation of the premature infant pain profile-revised (PIPP-R) in Brazil[J]. Pain Manag Nurs, 2019, 20(5): 512-515. doi: 10.1016/j.pmn.2019.02.002
[3]	WU H P, YIN T, HSIEH K H, et al. Integration of different sensory interventions from mother' s breast milk for preterm infant pain during peripheral venipuncture procedures: a prospective randomized controlled trial[J]. J Nurs Scholarsh, 2020, 52(1): 75-84. doi: 10.1111/jnu.12530
[4]	KAUR H, NEGI V, SHARMA M, et al. Study of pain response in neonates during venipuncture with a view to analyse utility of topical anaesthetic agent for alleviating pain[J]. Med J Armed Forces India, 2019, 75(2): 140-145. doi: 10.1016/j.mjafi.2017.12.009
[5]	BONJORN JUAREZ M, MANRIQUE PONS M, GRAU ALCÓN L, et al. Reduction of visual and auditory stimuli to reduce pain during venipuncture in premature infants. Study protocol for a randomized controlled trial[J]. J Adv Nurs, 2020, 76(4): 1077-1081. doi: 10.1111/jan.14300
[6]	DAVARI S, BORIMNEJAD L, KHOSRAVI S, et al. The effect of the facilitated tucking position on pain intensity during heel stick blood sampling in premature infants: a surprising result[J]. J Matern Fetal Neonatal Med, 2019, 32(20): 3427-3430. doi: 10.1080/14767058.2018.1465550
[7]	BELLIENI C V, TEI M, CORNACCHIONE S, et al. Pain perception in NICU: a pilot questionnaire[J]. J Matern Fetal Neonatal Med, 2018, 31(14): 1921-1923. doi: 10.1080/14767058.2017.1332038
[8]	OROVEC A, DISHER T, CADDELL K, et al. Assessment and management of procedural pain during the entire neonatal intensive care unit hospitalization[J]. Pain Manag Nurs, 2019, 20(5): 503-511. doi: 10.1016/j.pmn.2018.11.061
[9]	KRISTOFFERSEN L, MALAHLEHA M, DUZE Z, et al. Randomised controlled trial showed that neonates received better pain relief from a higher dose of sucrose during venepuncture[J]. Acta Paediatr, 2018, 107(12): 2071-2078. doi: 10.1111/apa.14567
[10]	SHUKLA V V, BANSAL S, NIMBALKAR A, et al. Pain control interventions in preterm neonates: a randomized controlled trial[J]. Indian Pediatr, 2018, 55(4): 292-296. doi: 10.1007/s13312-018-1270-z
[11]	USTA C, TANYERI-BAYRAKTAR B, BAYRAKTAR S. Pain control with lavender oil in premature infants: a double-blind randomized controlled study[J]. J Altern Complement Med, 2021, 27(2): 136-141. doi: 10.1089/acm.2020.0327
[12]	XIE W H, WANG X J, HUANG R H, et al. Assessment of four pain scales for evaluating procedural pain in premature infants undergoing heel blood collection[J]. Pediatr Res, 2021, 89(7): 1724-1731. doi: 10.1038/s41390-020-1034-z
[13]	DÖRA Ö, BVYVK E T. Effect of white noise and lullabies on pain and vital signs in invasive interventions applied to premature babies[J]. Pain Manag Nurs, 2021, 22(6): 724-729. doi: 10.1016/j.pmn.2021.05.005
[14]	贺芳, 刘会, 曹蕾, 张喆, 等. 非营养性吸吮与口服葡萄糖对早产儿足跟采血疼痛的影响[J]. 护理学杂志, 2020, 35(13): 16-18. doi: 10.3870/j.issn.1001-4152.2020.13.016 HE F, LIU H, CAO L, ZHANG Z, et al. Effect of non-nutritive sucking and oral feeding with glucose on pain during heel prick for blood sampling in preterm neonates[J]. Journal of Nursing, 2020, 35(13): 16-18. doi: 10.3870/j.issn.1001-4152.2020.13.016
[15]	HENDY A, ALSHARKAWY S S, EL-NAGGER N S. The outcomes of a healing environment and clustering nursing care on premature infants' vital signs, pain, and sleeping[J]. J Med Life, 2022, 15(11): 1347-1351. doi: 10.25122/jml-2022-0253
[16]	李家菁, 史丽丽, 程丽娜, 等. 多感官干预对新生儿静脉穿刺疼痛的影响[J]. 护理学杂志, 2023, 38(14): 38-40. doi: 10.3870/j.issn.1001-4152.2023.14.038 LI J J, SHI L L, CHEN L N, et al. Effect of multisensory intervention on neonatal venipuncture pain[J]. Journal of Nursing, 2023, 38(14): 38-40. doi: 10.3870/j.issn.1001-4152.2023.14.038
[17]	DAVARI S, BORIMNEJAD L, KHOSRAVI S, et al. The effect of the facilitated tucking position on pain intensity during heel stick blood sampling in premature infants: a surprising result[J]. J Matern Fetal Neonatal Med, 2019, 32(20): 3427-3430. doi: 10.1080/14767058.2018.1465550
[18]	范敏, 陈信, 张阵, 等. 早产儿喂养不耐受临床特征及相关影响因素的研究[J]. 中华全科医学, 2022, 20(3): 431-434, 449. doi: 10.16766/j.cnki.issn.1674-4152.002370 FAN M, CHEN X, ZHANG Z, et al. Clinical characteristics and risk factors of feeding intolerance in preterm infants[J]. Chinese Journal of General Practice, 2022, 20(3): 431-434, 449. doi: 10.16766/j.cnki.issn.1674-4152.002370
[19]	ZWISSIG M, RIO L, ROTH-KLEINER M, et al. Measurement of stress in stable neonates during ambulance transportation: a feasibility study[J]. Aust Crit Care, 2019, 32(1): 28-33. doi: 10.1016/j.aucc.2018.06.006
[20]	BOURGOIN L, CAEYMAEX L, DECOBERT F, et al. Administering atropine and ketamine before less invasive surfactant administration resulted in low pain scores in a prospective study of premature neonates[J]. Acta Paediatr, 2018, 107(7): 1184-1190. doi: 10.1111/apa.14317