预防新生儿足底采血疼痛的最佳证据总结

doi:10.16460/j.issn1008-9969.2019.11.045

摘要/Abstract

摘要： 目的评价、总结国内外预防新生儿足底采血疼痛的最佳证据,为减轻新生儿足底采血疼痛提供证据支持。方法系统检索中国知网（CNKI）、中国生物医学文献数据库、万方数据库、Up To Date、PubMed、JBI、Cochrane图书馆、美国指南网（National guideline clearinghouse, NGC）、美国儿科协会和加拿大儿科麻醉协会,包括指南、证据总结、最佳实践信息册、推荐实践、系统评价、专家共识类文献。检索时限为从建库至2019年4月31日。由2名研究者对文献质量进行评价和资料提取。结果共纳入文献15篇,包括指南3篇,证据总结5篇,最佳实践信息册1篇,系统评价6篇。从15 篇文献中共提取了49 条证据,整合成5 个维度, 分别为新生儿足底采血疼痛识别、医护人员培训、操作流程、疼痛评估、疼痛干预,形成了21条最佳证据。结论应加强护理人员新生儿疼痛护理的培训,选择合适的新生儿疼痛评估工具进行操作前的疼痛评估。由于护理的人文背景及证据的不断更新,应用证据时需结合医院特点和临床背景,有针对性地选择证据。

关键词: 新生儿, 足底采血, 疼痛, 循证护理

Abstract: Objective To summarize and evaluate the best available evidence on pain relief in capillary blood sampling. Methods We searched CNKI, the CBM, Wanfang Database, Up To Date, PubMed、JBI、Cochrane Library, National guideline clearinghouse(NGC), American Academy of Pediatrics(APP) and Canadian Pediatric Anesthesia Association to collect evidences including guideline, evidence summary, best practice information booklet, recommendations, expert consensus and systematic review from the inception of databases to April 31, 2019. Two researchers independently assessed the quality and extracted data. Results Fifteen articles were enrolled, including 3 guidelines, 5 evidence summaries, 1 best practice information booklet and 6 systematic review and 49 evidences were extracted, which were integrated into 5 dimensions: pain recognition in heel prick, medical personnel training, operation procedure, pain assessment and intervention. Conclusion More training of neoate pain nursing is needed for nursing staff and pain assessment with a practical tool before heel prick is required. For continuous updating of the evidence and the humanistic background of nursing, evidences should be chosen considering the characteristics of the hospital and clinical environment.

Key words: neonate, heel prick, pain, evidence-based nursing

中图分类号:

R473.72

王瑞娜, 赖晓帆, 刘秋利, 张婷婷, 梁琼文, 倪丹霞. 预防新生儿足底采血疼痛的最佳证据总结[J]. 护理学报, 2019, 26(11): 45-48.

WANG Rui-na, LAI Xiao-fan, LIU Qiu-li, ZHANG Ting-ting, LIANG Qiong-wen, NI Dan-xia. Best Evidence Summary for Pain Relief of Capillary Blood Sampling[J]. Journal of Nursing, 2019, 26(11): 45-48.

参考文献

[1] World Health Organization. Preterm Birth[EB/OL]. [2014-09-01].http://www.who.int/mediacentre/factsheets/fs363/en/.
[2] Anand K J. Assessment of Neonatal Pain[EB/OL].(2018-07-26)[2019-04-01].https://www-uptodate-com.uchile.idm.oclc.org/contents/assessment-of-neonatal-pain?search=Assessment%20of%20neonatal%20pain&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1.
[3] Carbajal R, Rousset A, Danan C, et al.Epidemiology and Treatment of Painful Procedures in Neonates in Intensive Care Units[J]. JAMA,2008,300(1):60-70.DOI:10.1001/jama.300.1.60.
[4] Koban M, Leis S, Schultze-Mosgau S, et al.Tissue Hypoxia in Complex Regional Pain Syndrome[J]. Pain,2003,104(1/2):149-157.
[5] Childambaram A G, Manjula S, Adhisivam B, et al.Effect of Kangaroo Mother Care in Reducing Pain Due to Heel Prick among Preterm Neonates: A Crossover Trial[J]. J Maternal Fetal Neonatal Med,2014,27(5):488-490.DOI:10.3109/14767058.
[6] AAP, Committee on Fetus and Newborn and Section on Anesthesiology and Pain Medicine. Prevention and Management of Procedural Pain in the Neonate: An Update[J]. Pediatrics,2016,137(2):e20154271.DOI:10.1542/ peds.2015-4271.
[7] Sandra L, Deborah D.Johns Hopkins Nursing Evidencebased Practice Model and Guidelines[M]. Indiana:Sigma Theta Tau International,2007:204-207.
[8] Dicenso A, Bayley L, Haynes R B.Accessing Pre-appraised Evidence: Fine-tuning the 5s Model into a 6s Model[J]. Evid Based Nurs, 2009,12(4):99-101.DOI:10.1136/ebn.12.4.99-b.
[9] 熊俊,陈日新. 系统评价/Meta分析方法学质量的评价工具AMSTAR[J]. 中国循证医学杂志,2011,11(9):1084-1089.
[10] The Joanna Briggs Institute. Critical Appraisal Checklist for Text and Opinion[EB/OL]. [2018-11-22]. http://joannabriggs. org/research/critical-appraisal-tools.html.
[11] The Joanna Briggs Institute. Critical Appraisal Checklist for Randomized Controlled Trials[EB/OL]. [2018-11-22]. http://joannabriggs.org/research/critical-appraisal-tools.html.
[12] The Joanna Briggs Institute. Critical Appraisal Checklist for Quasi-experimental Studies[EB/OL]. [2018-11-22]. http://joannabriggs.org/research/critical-appraisal-tools.html.
[13] 王春青,胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志,2015,11(11):964-967.
[14] Paola Lago, Elisabetta Garetti,Daniele Merazzi,et al. Guidelines for Procedural Pain in the Newborn. Acta Paediatr[J].2009,98(6)932-939.DOI:10.1111/j.1651-2227.2009.01291.x.
[15] 陶莉,周伟. 新生儿操作性疼痛治疗指南[J].实用儿科临床杂志,2011,26(2):149-152.
[16] Anand K J. Prevention and Treatment of Neonatal Pain[EB/OL].[2019-01-14](2019-04-01). https://www-uptodate-com.uchile.idm.oclc.org/contents/prevention-and-treatment-of-neonatal-pain?search=Assessment%20of%20neonatal%20pain&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2.
[17] Anand K J,Johnston C C, Oberlander T F, et al.Analgesia and Local Anesthesia During Invasive Procedures in the Neonate[J]. Clin Ther,2005,27(6):844-876.
[18] Anand K J.Consensus Statement for the Prevention and Management of Pain in the Newborn[J]. Arch Pediatr Adolesc Med,2001,155(2):173-180.
[19] 沈巧,郑显兰,李霞,等.儿童疼痛管理相关临床实践指南内容分析[J].护理学杂志,2018,33(7):50-53. DOI:10.3870/j.issn.1001-4152.2018.07.050.
[20] 卫生部.新生儿疾病筛查技术规范(2010版)[EB/OL] [2010-12-01].http://www.nhc.gov.cn/cms-search/xxgk/getManuscriptXxgk.htm?id=50065.
[21] Taddio A, Ohlsson A, Einarson T R, et al.A Systematic Review of Lidocaine-prilocaline Cream (EMLA) in the Treatment of Acute Pain in Neonates[J]. Pediatrics,1998,101(2):E1.
[22] Harrison D, Larocque C, Bueno M, et al.Sweet Solutions to Reduce Procedural Pain in Neonates: A Meta-analysis[J]. Pediatrics,2017,139(1):e20160955.DOI:10.1542/peds.2016-0955.
[23] Stevens B, Yamada J, Ohlsson A, et al. Sucrose for Analgesia in Newborn Infants Undergoing Painful Procedures[J].Cochrane Database Syst Rev,2016,16(7):CD001069. DOI: 10.1002/14651858.
[24] Nicole Mracine, Hannah G Gennis, Kara Turcotte, et al. Non-pharmacological Management of Infant and Young Child Procedural Pain[J]. Cochrane Database Syst Rev, 2015,2(12):CD006275. DOI:10.1002/14651858.
[25] Harrison D, Reszel J, Bueno M, et al. Breastfeeding for Procedural Pain in Infants beyond the Neonatal Period[J]. Cochrane Database Syst Rev, 2016,28(10):CD011248.DOI: 10.1002/14651858.
[26] Johnston C, Campbell-Yeo M, Disher T,et al. Skin-to-skin Care for Procedural Pain in Neonates[J]. Cochrane Database Syst Rev, 2017,16(2):CD008435.DOI: 10.1002/14651858.
[27] 周英凤,胡雁,顾莺,等.基于证据的持续质量改进模式图的构建[J].中国循证医学杂志,2017,17(5):603-606.

相关文章 15

[1]	卢舒颖, 刘宁, 魏璐华, 梁冬梅, 李妍. 产后出血预防及管理的最佳证据总结[J]. 护理学报, 2020, 27(12): 18-22.
[2]	刘小成, 应文娟, 刘智利, 郑锐华, 许诺, 刘慧. 生命末期患者性与亲密关系评估的最佳证据总结[J]. 护理学报, 2020, 27(12): 23-27.
[3]	贺芳, 温秀兰, 林艳, 刘会, 郭晓萍, 张喆. 新生儿重症监护病房噪音水平调查与对策[J]. 护理学报, 2020, 27(12): 42-45.
[4]	高莹, 吴玉娥, 张建荣, 崔鑫浩, 陈淑玲, 叶丽芳, 杜秀珍. 基于循证构建轻症急性胰腺炎患者早期经口进食时机评估及管理方案[J]. 护理学报, 2020, 27(11): 11-15.
[5]	杨中善, 许妮娜, 詹昱新, 刘宁, 李昭慧, 乐格芬. 住院患者规范化身体约束管理最佳证据总结[J]. 护理学报, 2019, 26(4): 31-36.
[6]	梁月, 王东梅, 徐金涛. 血液透析患者动静脉瘘穿刺疼痛影响因素及干预研究进展[J]. 护理学报, 2019, 26(14): 38-42.
[7]	裴一洁, 党娟, 凌继祖, 杨学梅. 1例新生儿下肢PICC致腰背部脓肿的原因分析与预防对策[J]. 护理学报, 2019, 26(13): 69-71.
[8]	刘雪莲,李漓. 临床护士疼痛管理核心能力知识水平现状分析[J]. 护理学报, 2018, 25(9): 12-16.
[9]	刘欢欢,王少萍,李斌,张燕,金威,李秋恋,符一兰. 1例梭形细胞脂肪瘤致低磷骨软化症合并肺部感染的护理[J]. 护理学报, 2018, 25(6): 51-53.
[10]	李飞,宋美璇,李显蓉. 长期留置导尿患者成功拔除导尿管的最佳指南意见[J]. 护理学报, 2018, 25(5): 1-5.
[11]	陈敬芳,王晓燕,李旺. 足踝部定量活动仪辅助踝泵运动对骨科患者术后疼痛及股静脉血液回流的影响[J]. 护理学报, 2018, 25(4): 1-4.
[12]	胡冠兰,顾颖,苏天兰,时利群,张文静,石艳照. 不同浓度利多卡因湿敷对保守性锐器清创镇痛效果分析[J]. 护理学报, 2018, 25(4): 15-18.
[13]	许颖,蒋小平,林楠,雷若冰. 697名无陪护新生儿病区护士实施身体评估影响因素的现状调查[J]. 护理学报, 2018, 25(4): 45-48.
[14]	邹丽, 郑雅宁, 吴瑜玲. 剖宫产术后医用皮肤接触组合母子衣的研制[J]. 护理学报, 2018, 25(22): 77-78.
[15]	黄培培, 米元元, 吴白女, 陈肖敏, 周明, 鲍映雪, 张琼, 杨喜群, 史平. 肿瘤患者术中非计划性低体温预防及管理的证据总结[J]. 护理学报, 2018, 25(21): 33-39.

Metrics

Viewed

Full text

Abstract

Cited

Shared