CAJ | 학술논문

　　目的探讨袋鼠式护理在减轻新生儿足跟采血疼痛的效果。方法将行足跟采血的60例新生儿随机分为干预组与对照组，每组各30例，干预组从足跟采血前20 min至足跟采血结束后1 min实施袋鼠式护理，对照组按常规护理。比较从足跟采血前10 s至足跟采血结束后10 s 8个时间点两组新生儿心率、血氧饱和度、面部疼痛表情、啼哭持续时间和新生儿急性疼痛行为评分量表（douleur aigue nouveaune，DAN）评分情况。结果足跟采血后7个时间点新生儿心率重复测量资料分析结果：时间与主效应的交互效应比较，P＜0.01，说明两组新生儿不同时间点心率是不相等的；时间效应比较，P＜0.01，说明随着时间的延长，两组新生儿心率具有加快的趋势；两组新生儿穿刺后7个时间点心率比较，差异具有统计学意义（均P＜0.05），干预组新生儿心率变化幅度较少。足跟采血后7个时间点两组新生儿血氧饱和度重复测量资料分析结果：时间与主效应的交互效应比较，P＜0.05，说明两组新生儿不同时间点血氧饱和度是不相等的；时间效应比较，P＜0.05，说明随着时间的延长，两组新生儿血氧饱和度具有降低的趋势；两组新生儿穿刺时30 s、40 s、50 s及穿刺后血氧饱和度比较，差异具有统计学意义（均P＜0.05），干预组新生儿血氧饱和度变化幅度较少。干预组新生儿啼哭持续时间明显短于对照组，DAN评分明显低于对照组（均P＜0.05）。结论足跟采血可引起新生儿中重度疼痛，袋鼠式护理可有效缓解足跟采血时新生儿的疼痛程度。
　　목적탐토대서식호리재감경신생인족근채혈동통적효과。방법장행족근채혈적60례신생인수궤분위간예조여대조조，매조각30례，간예조종족근채혈전20 min지족근채혈결속후1 min실시대서식호리，대조조안상규호리。비교종족근채혈전10 s지족근채혈결속후10 s 8개시간점량조신생인심솔、혈양포화도、면부동통표정、제곡지속시간화신생인급성동통행위평분량표（douleur aigue nouveaune，DAN）평분정황。결과족근채혈후7개시간점신생인심솔중복측량자료분석결과：시간여주효응적교호효응비교，P＜0.01，설명량조신생인불동시간점심솔시불상등적；시간효응비교，P＜0.01，설명수착시간적연장，량조신생인심솔구유가쾌적추세；량조신생인천자후7개시간점심솔비교，차이구유통계학의의（균P＜0.05），간예조신생인심솔변화폭도교소。족근채혈후7개시간점량조신생인혈양포화도중복측량자료분석결과：시간여주효응적교호효응비교，P＜0.05，설명량조신생인불동시간점혈양포화도시불상등적；시간효응비교，P＜0.05，설명수착시간적연장，량조신생인혈양포화도구유강저적추세；량조신생인천자시30 s、40 s、50 s급천자후혈양포화도비교，차이구유통계학의의（균P＜0.05），간예조신생인혈양포화도변화폭도교소。간예조신생인제곡지속시간명현단우대조조，DAN평분명현저우대조조（균P＜0.05）。결론족근채혈가인기신생인중중도동통，대서식호리가유효완해족근채혈시신생인적동통정도。
Objective To investigate the effect of Kangaroo care(KC)on diminishing neonatal pain during heel lancing. Methods Sixty neonates were divided randomly into two equal groups:intervention group and control group,which 30 cases in each group.In the intervention group,neonates were treated with KC(neonates were put in direct and continuous skin-to-skin contact with his/her mom)from 20 mins before heel lancing to 1 mins after the end of the lancing.In the control group,neonates were treated with regular care.The differences in heart rate,blood oxygen saturation,facial pain expression,crying duration and DAN(Douleur Aigue Nouveaune)scores between two groups were compared at 7 time points from 10s before the heel lancing to 10s after the lancing. Results The results of repeated measu te at 7 time points after heel lancing.There were significant interaction effect between time and main effect(P<0.01),which showed that the heart rate of two groups were not equal at different time points.Compared with the time effects(P<0.01)which showed that two groups of neonatal heart rate of the two groups would accelerate with time extension. There were significant differences(all P<0.05)in heart rate at 7 time points between two groups and smaller heart rate varied range in intervention group.The results of repeated measures analysis for neonatal blood oxygen saturation at 7 time points after heel lancing. There were significant interaction effect between time and main effects(P<0.01),which showed that the blood oxygen saturation of two groups were not equal at different time points.Compared with the time effect(P<0.01),which showed that two groups of neonatal blood oxygen saturation would reduce with time extension.There were significant differences(all P<0.05)in blood oxygen saturation of two groups at 30s,40s and 50s after heel lancing and smaller blood oxygen saturation varied range in intervention group.The crying duration and DAN scores in intervention group were significantly reduced compared with the controls(all P<0.05).Conclusions <br> Heel lancing could lead to moderate to severe pain of neonates.KC could effectively diminish the neonatal pain degree caused by heel lancing.