Ludington-Hoe Susan M, Hosseini Robert, Torowicz Deborah L
FP Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio 44106-4904, and the Pediatric Critical Care Center, Children's Hospital of New Jersey, Newark, USA.
AACN Clin Issues. 2005 Jul-Sep;16(3):373-87. doi: 10.1097/00044067-200507000-00010.
The purpose of the study was to compare a heel stick conducted during Kangaroo Care (skin-to-skin contact) with the mother to a heel stick in a warmer in reducing premature infant physiologic and behavioral pain responses. Twenty-four premature infants in a university-based neonatal intensive care unit were recruited and randomized to 2 sequences: sequence A group received 3 hours of Kangaroo Care (with a heel stick in Kangaroo Care) followed by 3 hours in a warmer (with a heel stick in the warmer). Sequence B group had warmer care and a heel stick (in the warmer) before Kangaroo Care and a heel stick (in Kangaroo Care). Heart rate, respiratory rate, oxygen saturation, crying time, and behavioral state were measured before, during, and after heel stick. Repeated measures ANOVA and Mann Whitney U statistics were performed. Heart rate and length of crying in response to pain were significantly reduced during Kangaroo Care and the Kangaroo Care heel stick as compared to when infants were in the warmer and had a heel stick in the warmer. Three infants did not cry at all during the Kangaroo Care heel stick; infants slept more during Kangaroo Care than in the warmer. Kangaroo Care positioning before and during heel stick is a simple and inexpensive analgesic intervention to ameliorate pain in stable premature infants.
本研究的目的是比较在袋鼠式护理（皮肤接触）期间与母亲进行足跟采血和在暖箱中进行足跟采血对减少早产儿生理和行为疼痛反应的影响。一所大学附属医院的新生儿重症监护病房招募了24名早产儿，并将其随机分为2组：A组先接受3小时的袋鼠式护理（在袋鼠式护理期间进行足跟采血），然后在暖箱中待3小时（在暖箱中进行足跟采血）。B组在接受袋鼠式护理之前和期间先在暖箱中护理并进行足跟采血（在暖箱中），然后在袋鼠式护理期间进行足跟采血（在袋鼠式护理时）。在足跟采血前、采血期间和采血后测量心率、呼吸频率、血氧饱和度、哭闹时间和行为状态。采用重复测量方差分析和曼-惠特尼U检验。与婴儿在暖箱中且在暖箱中进行足跟采血相比，在袋鼠式护理期间以及在袋鼠式护理时进行足跟采血时，因疼痛引起的心率和哭闹时间显著降低。在袋鼠式护理时进行足跟采血期间，有3名婴儿根本没有哭闹；婴儿在袋鼠式护理期间比在暖箱中睡眠更多。在足跟采血前和采血期间进行袋鼠式护理体位是一种简单且经济的镇痛干预措施，可减轻稳定早产儿的疼痛。
