新生儿疼痛评估方法的研究进展

陈永强, 王景刚, 庞伟, 曹建国

中国儿童保健杂志 ›› 2025, Vol. 33 ›› Issue (6) : 643-647.

PDF(585 KB)
PDF(585 KB)
中国儿童保健杂志 ›› 2025, Vol. 33 ›› Issue (6) : 643-647. DOI: 10.11852/zgetbjzz2024-0359
综述

新生儿疼痛评估方法的研究进展

  • 陈永强1,2,3, 王景刚3, 庞伟1,2, 曹建国3
作者信息 +

Research progress of neonatal pain assessment methods

  • CHEN Yongqiang1,2, WANG Jinggang3, PANG Wei1,2, CAO Jianguo3
Author information +
文章历史 +

摘要

由于新生儿无法描述疼痛且神经系统尚未发育完全,对疼痛的感知和表达不同于成人,临床工作中往往忽视了新生儿疼痛。而疼痛会导致人的心理情绪、内分泌、循环系统、呼吸系统等都受到影响,并出现相应的症状。本文对目前常用的新生儿疼痛评估量表的优缺点进行了概述,同时探讨了唾液皮质醇在新生儿疼痛评估中的潜在应用价值,以期为准确客观的新生儿疼痛评估提供参考方法和理论依据。

Abstract

Due to the fact that newborns cannot describe pain and their nervous systems are not fully developed, their perception and expression of pain differ from adults. Consequently, neonatal pain is often overlooked in clinical practice. However, pain can affect individuals′ psychological emotions, endocrine system, circulatory system, respiratory system, and other aspects, leading to corresponding symptoms. This article summarizes the advantages and disadvantages of currently used neonatal pain assessment scales and explores the potential application value of salivary cortisol in neonatal pain assessment, aiming to provide reference and theoretical basis for accurate and objective pain assessment in newborns.

关键词

疼痛 / 评估 / 唾液皮质醇 / 新生儿

Key words

pain / evaluation / salivary cortisol / newborn

引用本文

导出引用
陈永强, 王景刚, 庞伟, 曹建国. 新生儿疼痛评估方法的研究进展[J]. 中国儿童保健杂志. 2025, 33(6): 643-647 https://doi.org/10.11852/zgetbjzz2024-0359
CHEN Yongqiang, WANG Jinggang, PANG Wei, CAO Jianguo. Research progress of neonatal pain assessment methods[J]. Chinese Journal of Child Health Care. 2025, 33(6): 643-647 https://doi.org/10.11852/zgetbjzz2024-0359
中图分类号: R179   

参考文献

[1] Xie WH, Wang XJ, Huang RH, et al. Assessment of four pain scales for evaluating procedural pain in premature infants undergoing heel blood collection[J]. Pediatr Res, 2021,89(7):1724-1731.
[2] Selvanathan T, Miller SP. Effects of pain, sedation and analgesia on neonatal brain injury and brain development[J]. Semin Perinatol, 2024,48(5): 151928.
[3] 林思雅, 李漓, 任许艳. 新生儿术后疼痛评估工具的应用进展[J]. 中华急危重症护理杂志, 2022,3(4):376-380.
Lin SY, Li L, Ren XY.Application progress of neonatal postoperative pain assessment tools[J].Chin J Emerg Crit Care Nurs, 2022,3(4):376-380. (in Chinese)
[4] 黄雯琦, 卿雁冰, 马丽芳, 等. 早产儿疼痛特异性评估量表及其应用的研究进展[J]. 中国儿童保健杂志, 2022,30(10):1099-1103.
Huang WQ, Qing YB, Ma LF, et al. Research progress in the Pain-Specific Assessment Scales and its application in preterm infants[J]. Chin J Child Health Care, 2022, 30(10): 1099-1103. (in Chinese)
[5] 何星蓉, 郑显兰, 柯淞淋, 等. 基于3个英文版新生儿疼痛量表评估新生儿术后疼痛的信度和效度研究[J]. 中国循证儿科杂志, 2021,16(3):186-191.
He XR, Zheng XL, Ke SL, et al. Study on the reliability and validity of three English versions of the neonatal pain scale for assessing postoperative pain in neonates[J].Chin J Evid Based Pediatr,2021,16(3):186-191. (in Chinese)
[6] Xie W, Wang X, Huang R, et al. Assessment of four pain scales for evaluating procedural pain in premature infants undergoing heel blood collection[J].Pediatr Res,2021,89(7):1724-1731.
[7] Bueno M, Moreno-Ramos MC, Forni E, et al. Adaptation and Initial Validation of the Premature Infant Pain Profile-Revised (PIPP-R) in Brazil[J]. Pain Manag Nurs, 2019,20(5):512-515.
[8] Shukla VV, Bansal S, Nimbalkar A, et al. Pain control interventions in preterm neonates: A randomized controlled trial[J]. Indian pediatr,2018,55(4):292-296.
[9] 吴巍巍, 路英慧, 程丹, 等. 烧伤患儿的疼痛评估及非药物干预研究进展[J].中华烧伤杂志, 2020,36(1):76-80.
Wu WW, Lu YH, Cheng D, et al. Research progress on pain assessment and non-pharmacological intervention in burned children[J].Chin J Burns,2020,36(1):76-80. (in Chinese)
[10] Napiórkowska-Orkisz M, Gutysz-Wojnicka A, Tanajewska M, et al. Evaluation of methods to minimize pain in newborns during capillary blood sampling for screening: A randomized clinical trial[J].Int J Environ Res Public Health, 2022,19(2):870.
[11] Wang Y, Li Y, Sun J, et al. Factors influencing the occurrence of neonatal procedural pain[J]. J Spec Pediatr Nurs, 2020,25(2) :e12281.
[12] Boyle EM, Bradshaw J, Blake KI. Persistent pain in neonates: Challenges in assessment without the aid of a clinical tool[J]. Acta Paediatr, 2018,107(1):63-67.
[13] Luo FX, Zhu HY, Mei LL, et al. Evaluation of procedural pain for neonates in a neonatal intensive care unit: A single-centre study[J].BMJ paediatr open,2023,7(1) :e002107.
[14] Chen Y, Tong Y, Xue Z, et al. Evaluation of the reliability and validity of the Behavioral Indicators of Infant Pain Scale in Chinese neonates[J].Pain Manag Nurs, 2020,21(5):456-461.
[15] Glenzel L, Do Nascimento Oliveira P, Marchi BS, et al. Validity and reliability of Pain and Behavioral Scales for preterm infants: A systematic review[J].Pain Manag Nurs, 2023,24(5):e84-e96.
[16] 吴怡雪,陈易,邱文波,等.婴儿疼痛行为指征量表的汉化及信效度检验[J].中国疼痛医学杂志,2021,27(11):835-840.
Wu YX, Chen Y, Qiu WB, et al. Chinese version of the Infant Pain Behavior Indicators Scale: Translation and validation of reliability and validity[J]. Chin J Pain Med, 2021, 27(11): 835-840. (in Chinese)
[17] Morgan ME, Kukora S, Nemshak M, et al. Neonatal Pain, Agitation, and Sedation Scale′s use, reliability, and validity:A systematic review[J].J Perinatol, 2020,40(12):1753-1763.
[18] Dincer E, Özer H, Topçuoğlu S, et al. Ultrasonography causes agitation and pain leading to hemodynamic disturbance in neonates: A prospective observational study[J]. Child, 2023,10(2):347.
[19] 邵珍珍, 朱琳, 唐文娟, 等. 儿童术后疼痛评估工具研究进展[J]. 护理学杂志, 2021,36(5):102-108.
Shao ZZ, Zhu L, Tang WJ, et al. Research progress of postoperative pain assessment tools for children[J]. J Nurs Sci, 2021, 36(5): 102-108. (in Chinese)
[20] Herr K, Coyne PJ, Ely E, et al. Pain assessment in the patient unable to self-report: Clinical practice recommendations in support of the ASPMN 2019 position statement[J]. Pain Manag Nurs, 2019,20(5):404-417.
[21] 林思雅, 谌靖霞, 李漓. 3种量表评估新生儿术后机械通气和非机械通气状态下疼痛的比较[J]. 护理管理杂志, 2023,23(2):100-104.
Lin SY, Chen JX, Li L. Comparison of three scales for assessing pain in neonates after surgery under mechanical ventilation and non-mechanical ventilation[J]. J Nurs Adm, 2023, 23(2): 100-104. (in Chinese)
[22] Arias MC, Guinsburg R. Differences between uni-and multidimensional scales for assessing pain in term newborn infants at the bedside[J].Clinics (Sao Paulo), 2012,67(10):1165-1170.
[23] Ahola KS, Pillai RR. Does the Neonatal Facial Coding System differentiate between infants experiencing pain-related and non-pain-related distress?[J]. J Pain, 2009,10(2):214-220.
[24] Huang XZ, Li L, Zhou J, et al. Evaluation of three pain assessment scales used for ventilated neonates[J]. J Clin Nurs, 2018,27(19-20):3522-3529.
[25] Kanbur BN, Mutlu B, Salihoglu O. Validity and reliability of the Neonatal Infant Acute Pain Assessment Scale (NIAPAS) in Turkish: Prospective study[J].Sao Paulo Med J, 2021,139(4):305-311.
[26] 林紫, 郑显兰, 何瑞云, 等. 兰氏新生儿疼痛评估量表用于机械通气新生儿急性疼痛评估的信效度分析[J]. 护理研究, 2020,34(21):3801-3806.
Lin Z, Zheng XL, He RY, et al.Reliability and validity analysis of Lan ′s neonatal pain assessment scale for acute pain assessment of neonates with mechanical ventilation[J].Nurs Res, 2020,34 (21):3801-3806. (in Chinese)
[27] Popowicz H, Kwiecień-Jagus′ K, Olszewska J, et al. Pain scales in neonates receiving mechanical ventilation in neonatal intensive care units-systematic review[J]. J Pain Res,2020, 13:1883-1897.
[28] Maxwell LG, Fraga MV, Malavolta CP. Assessment of pain in the newborn[J]. Clin Perinatol, 2019,46(4):693-707.
[29] Israel S, Perazzo S, Lee M, et al. Improving documentation of pain reassessment after pain management interventions in the NICU[J].Pediatr Qual Saf, 2023,8(5):e688.
[30] 沈巧,郑显兰,史源,等.中国新生儿疼痛管理循证指南(2023年)[J].中国当代儿科杂志,2023,25(2):109-127.
Shen Q, Zheng XL, Shi Y, et al. Evidence-based guidelines for neonatal pain management in China (2023)[ J ].Chin J Contemp Pediatr, 2023,25(2):109-127. (in Chinese)
[31] 蔡会文, 马月兰, 刘永戍, 等. 人工智能在新生儿疼痛评估中应用的研究进展[J]. 中华现代护理杂志, 2023,29(31):4325-4330.
Cai HW, Ma YL, Liu YS, et al. Research progress on the application of artificial intelligence in neonatal pain assessment[J].Chin J Mod Nurs,2023,29(31): 4325-4330. (in Chinese)
[32] Olszewska M, Pointinger-Tomasik S, Kwinta P. Assessment of salivary cortisol concentrations for procedural pain monitoring in newborns[J].J Perinat Med, 2023,51(4):564-572.
[33] Teixeira JG, Lima LTB, Cunha EC, et al. Association between cortisol levels and performance in clinical simulation:A systematic review[J]. Rev Esc Enferm USP, 2024,58:e20230279.
[34] Joung KH, Cho SC. The effect of sucrose on infants during a painful procedure[J]. Korean J Pediatr,2010,53(8):790.
[35] Badiee Z, Nassiri Z, Armanian A. Cobedding of twin premature infants: Calming effects on pain responses[J].Pediatr Neonatol,2014,55(4):262-268.
[36] Cignacco E, Denhaerynck K, Nelle M, et al. Variability in pain response to a non-pharmacological intervention across repeated routine pain exposure in preterm infants: A feasibility study[J]. Acta Paediatr, 2009,98(5):842-846.
[37] Mörelius E, He H, Shorey S. Salivary cortisol reactivity in preterm infants in neonatal intensive care: An integrative review[J]. Int J Environ Res Public Health, 2016,13(3):337.
[38] Gunnar MR, Talge NM, Herrera A. Stressor paradigms in developmental studies: What does and does not work to produce mean increases in salivary cortisol[J]. Psychoneuroendocrinology, 2009,34(7):953-967.
[39] Ivars K, Nelson N, Finnström O, et al. Nasopharyngeal suctioning does not produce a salivary cortisol reaction in preterm infants[J]. Acta Paediatr, 2012,101(12):1206-1210.
[40] Roué JM, Rioualen S, Gendras J, et al. Multi-modal pain assessment: Are near-infrared spectroscopy, skin conductance,salivary cortisol, physiologic parameters, and neonatal facial coding system interrelated during venepuncture in healthy, term neonates?[J]. J Pain Res, 2018,11:2257-2267.
[41] Lin S, Li L, Ren X, et al. Effects of white noise on pain scores and salivary cortisol levels in surgical neonates: A randomized controlled trial[J]. Adv Neonatal Care, 2024,24(3):291.

基金

广东省医学科学技术研究基金项目(A2022421);广东省高水平医院建设财政资金(ynkt2021-zz036)

PDF(585 KB)

Accesses

Citation

Detail

段落导航
相关文章

/