标题：抚触对减轻新生儿末梢血采集所致疼痛的效果观察

      作者：何静妍，梁琪琪，何苑仪，陈继雪    (广州市妇女儿童医疗中心产科二区，广东 广州 510120)

      卷次： 2018年29卷20期

      【摘要】 目的 探讨抚触对减轻新生儿采集末梢血所致疼痛的效果，以降低疼痛给新生儿带来的损伤。方法 选择2017年11~12月在广州市妇女儿童医疗中心产科二区分娩的正常足月的350例新生儿，按照随机数表法分为观察组和对照组，每组175例。两组新生儿均采集末梢血，其中观察组从出生第2天开始进行抚触，2次/d，对照组不给予任何干预措施。采用新生儿疼痛评分量表(neonatal infant pain scale，NIPS)评估两组新生儿疼痛程度，观察并比较两组新生儿采血前、中、后的哭闹持续时间、血氧饱和度和心率的变化。结果 观察组和对照组新生儿采血前的心率比较[(124.37±6.58)次/min vs (123.16±6.35)次/min]差异无统计学意义(P>0.05)；采血时和采血后心率均加快，观察组心率明显低于对照组[采血时，(145.82±7.06)次/min vs (161.53±7.41)次/min；采血后，(134.79±6.88)次/min vs (149.27±7.01)次/min]，差异均有显著统计学意义(P<0.01)；观察组新生儿采血中和采血后的疼痛评分明显低于对照组[采血中，(4.01±0.69)分 vs (5.47±0.73)分；采血后，(0.58±0.46)分 vs (1.03±0.51)分]，差异均有显著统计学意义(P<0.01)；两组新生儿采血前的血氧饱和度比较差异无统计学意义(P>0.05)；采血中和采血后，观察组新生儿血氧饱和度明显高于对照组[(91.43±2.44)% vs (83.51±2.37)%；(98.59±2.64)% vs (91.28±2.03)%]，差异有显著统计学意义(P<0.01)。结论 抚触能有效减轻新生儿采集时的疼痛，且操作简单、可行、安全，为非药物治疗缓解疼痛提供依据，值得在临床和社区推广应用。
      【关键词】 新生儿；抚触；疼痛；末梢血；采集
      【中图分类号】 R473.72 【文献标识码】 A 【文章编号】 1003—6350（2018）20—2858—03

Effect on touching to reliving the pain caused by neonatal peripheral blood collection.
HE Jing-yan, LIANG Qi-qi,HE Yuan-yi, CHEN Ji-xue. Guangzhou Women and Children's Medical Center, Second Department of Obstetrics,Guangzhou 510120, Guangdong, CHINA
【Abstract】 Objective To investigate the effect of touching on reliving the pain caused by neonatal peripheralblood collection, in order to reduce the injury of pain to the newborns. Methods A total of 350 newborns from October2015 to October 2017 in Guangzhou Women and Children's Medical Center were selected and divided into observationgroup (n=175) and control group (n=175). The peripheral blood samples were collected from the two groups of new-borns. The observation group applied touching intervention from the second day of birth, and the control group did notgive any intervention. The Neonatal Pain Score Scale was used to evaluate the pain degree and compare the changes ofcrying time, blood oxygen saturation and heart rate in the two groups of newborn infants before, during and after theblood collection. Results There was no significant difference in heart rate before blood sampling between the twogroups of newborns: (124.37±6.58) beats/min vs (123.16±6.35) beats/min, P>0.05. The heart rate at blood sampling andafter blood sampling were increased, and the rates in the observation group was significantly lower than that of the con-trol group: (145.82±7.06) vs (161.53±7.41) at blood sampling, P<0.01; (134.79±6.88) vs (149.27±7.01) after blood sam-pling, P<0.01. The pain scores of the newborn in the observation group were significantly lower than those of the controlgroup at and after blood collection: (4.01±0.69) vs (5.47±0.73), P<0.01; (0.58±0.46) vs (1.03±0.51), P<0.01. There wasno significant difference in blood oxygen saturation between the two groups before blood collection, but the blood oxy-gen saturation of the newborns in the observation group was higher than that in the control group at and after blood col-lection: (91.43±2.44) vs (83.51±2.37), P<0.01; (98.59±2.64) vs (91.28±2.03), P<0.01. Conclusion Touching can effec-tively alleviate the pain of the newborns during the peripheral blood collection, and maintain the life signs to be stable,which is worthy of clinical application.
      【Key words】 Newborn; Touching; Pain; Peripheral blood; Collection