RESUMO
Objective:To investigate the application value of oral stimulation combined with maternal milk sucking in the pain caused by PICC in children with congenital digestive tract malformations.Methods:Using convenience sampling method, 80 children with congenital digestive tract malformations who were admitted to Hunan Children's Hospital from July 2018 to December 2019 were selected and divided into the experimental group and the control group of 40 cases in each group according to the random number table method. The control group was given routine nursing mode, while the experimental group was given oral stimulation combined with maternal milk sucking intervention on the basis of routine nursing. The intervention effects were evaluated by the Neonatal Infant Pain Scale (NIPS), the onset time of the first cry, the duration of crying, the onset time of the first painful face, the duration of the painful face, and indicators such as heart rate, respiratory rate and SpO 2. Results:The NIPS scores of children in the experimental group were (5.60 ± 1.24) and (4.10 ± 0.31) in the puncture period and the recovery period, which were significantly lower than those in the control group (6.10 ± 0.84), (4.93 ± 0.35), the differences were statistically significant (t = 2.12, 3.00, both P<0.05). The heart rate and respiratory rate of the children in the experimental group were (151.10 ± 12.37), (147.00 ± 12.16) times/min and (47.48 ± 7.59), (45.58 ± 6.51) times/min in the puncture period and the recovery period, which were significantly lower than those in the control group (159.75 ± 13.81), (156.05 ± 12.99) times/min and (52.38 ± 8.12), (49.75 ± 7.59) times/min, the differences were statistically significant (t values were 2.64-3.22, all P<0.05). The SpO 2 in the experimental group were 0.980 5 ± 0.009 0, 0.982 5 ± 0.010 8 in the puncture period and the recovery period, which were significantly higher than those in the control group 0.970 8 ± 0.014 2, 0.971 8 ± 0.018 1, the differences were statistically significant (t = 3.66, 3.23, both P<0.05). The onset time of the first cry, the duration of crying, the onset time of the first painful face, the duration of the painful face in the experimental group were (41.55 ± 6.38), (22.05 ± 4.47), (35.08 ± 5.94), (24.65 ± 5.46) s, significantly shorter than those in the control group (46.58 ± 5.26), (29.50 ± 6.48), (44.68 ± 13.31), (30.65 ± 9.42) s, the differences were statistically significant (t values were 2.63-5.98, all P<0.05). Conclusions:Oral stimulation combined with maternal milk sucking can effectively relieve the pain caused by PICC in children with congenital digestive tract malformation, and reduce the physiological stress response of children.
RESUMO
Objective@#To investigate the application of music intervention in combination with maternal voice during PICC placement procedures in malformation alimentary tract infants.@*Methods@#A total of 60 malformation alimentary tract infants were enrolled in the present study in Hunan Children Hospital from January to December 2018, infants were randomly assigned to the intervention group (n=30) and the control group (n=30). Patients in the control group received conventional nursing, the intervention group received music and maternal voice intervention method. The level changes of heart rate, respiratory rate, blood pressure, blood oxygen saturation and cortisol concentration were compared between two groups, meanwhile, the pain rating were assessed by Neonatal Infant Pain Scale (NIPS).@*Results@#Before procedure, no significant difference was found between the control and intervention group in heart rate, respiratory rate, systolic pressure, SpO2 and NIPS score (P>0.05). During and after the procedure, the mean heart rate [(144.43±15.93), (142.43±20.42) times/min], respiratory rate [(44.70±4.51) and (43.50± 4.12) times/min], systolic pressure [(87.40±8.53) and (86.10±4.60) mmHg] and NIPS score (5.34±0.71 and 5.19±0.87) of the intervention group was statistically lower compared to the control group [(160.97±39.35) and (159.17±31.87) times/min, (53.13±7.85) and (50.47±7.70) times/min, (97.60±9.82) and (94.27±7.23) mmHg, 6.17±0.54 and 6.15±0.66; during procedure, the mean SpO2 was statistically significantly higher, compared to the control group [(96.15±9.82)% versus (88.34±9.53)%]. The difference was statistically significantly (t=2.134-6.682, P<0.05). Before placement, the concentration of cortisol between the two groups showed no significant difference (P>0.05), and (208.91±21.07)ng/ml 5min after placement and (197.70±16.34) ng/ml immediately after placement, the cortisol concentration was statistically significantly lower, compared to the control group [(246.71±35.15), (230.95±21.81) ng/ml] (t=5.050-6.682, P<0.05). Compared with the control group, the time needed for PICC placement decreased remarkably in the intervention group [(15.62±3.30) min versus (24.63±4.26) min)](t=9.160, P<0.01).@*Conclusions@#Music in combination with maternal voice can significantly reduce stress levels, pain responses and time need for PICC placement, music and maternal voice is a potential intervention strategy in malformation alimentary tract infants undergoing PICC.