Slevin M, Murphy J F, Daly L, O'Keefe M
Department of Neonatology, National Maternity Hospital, Dublin, Ireland.
Br J Ophthalmol. 1997 Sep;81(9):762-4. doi: 10.1136/bjo.81.9.762.
AIMS/BACKGROUND: In a prospective study the degree of distress caused by retinopathy of prematurity (ROP) screening in a cohort of preterm infants was assessed and the modifying effects of nesting in reducing their discomfort was evaluated.
38 preterm infants were included in the study. 19 infants were placed in a nest with boundaries (intervention group) and 19 infants were placed on a cot blanket (control group). Observations were made 2 minutes before, throughout, and 2 minutes after ROP examination. The factors observed were crying responses, neurobehavioural activity, and physiological changes (heart rate, oxygen saturation). Recordings were made using a video camera for crying and neurobehavioural activity and an Oxypleth monitor for heart rate and oxygen saturation.
During ROP screening, the total group of 38 infants (nested and non-nested combined) displayed increased neurobehavioural activity (p < 0.01) and crying (p < 0.01). The increased activity and crying coincided with the invasive part of the procedure. The distress caused by ROP screening was significantly less for the nested group compared with the non-nested group for both movement activity (p < 0.01) and crying (p < 0.01). The physiological data, heart rate, and oxygen saturation were not statistically significant.
ROP screening is distressing for preterm infants. Nesting can significantly reduce this discomfort. The findings in this study are of value in designing more optimal ROP examination schedules for infants.
目的/背景：在一项前瞻性研究中，评估了一组早产儿因早产儿视网膜病变（ROP）筛查所引起的痛苦程度，并评估了使用襁褓对减轻其不适的调节作用。
38名早产儿纳入本研究。19名婴儿被放置在有边界的襁褓中（干预组），19名婴儿被放置在婴儿床毯子上（对照组）。在ROP检查前2分钟、检查期间及检查后2分钟进行观察。观察的因素包括哭闹反应、神经行为活动和生理变化（心率、血氧饱和度）。使用摄像机记录哭闹和神经行为活动，使用脉搏血氧监测仪记录心率和血氧饱和度。
在ROP筛查期间，38名婴儿（包括使用襁褓和未使用襁褓的婴儿）的神经行为活动（p<0.01）和哭闹（p<0.01）均增加。活动和哭闹的增加与检查的侵入性部分同时发生。与未使用襁褓的组相比，使用襁褓的组在运动活动（p<0.01）和哭闹（p<0.01）方面，ROP筛查引起的痛苦明显更少。生理数据、心率和血氧饱和度无统计学意义。
ROP筛查会使早产儿感到痛苦。使用襁褓可显著减轻这种不适。本研究结果对于为婴儿设计更优化的ROP检查方案具有重要价值。
