以质量求发展，以服务铸品牌

护理学报 ›› 2019, Vol. 26 ›› Issue (22): 6-10.doi: 10.16460/j.issn1008-9969.2019.22.006

• 研究生园地 • 上一篇    下一篇

母亲心音联合话音刺激对NICU早产儿心率及行为状态的影响

李倩1, 涂素华2, 李雨昕3, 谭琳3, 罗珊3, 陈丽3   

  1. 1.重庆医科大学附属儿童医院 新生儿诊治中心,儿童发育疾病研究教育部重点实验室,儿科学重庆市重点实验室,国家儿童健康与疾病临床医学研究中心,儿童发育重大疾病国家国际科技合作基地,重庆 400014;
    2.西南医科大学附属医院 妇产科,四川 泸州 646000;
    3.西南医科大学 护理学院,四川 泸州 646000
  • 收稿日期:2019-04-04 发布日期:2020-07-27
  • 通讯作者: 陈 丽（1965-）,女,四川泸州人,本科,教授,硕士研究生导师。E-mail：294344405@qq.com
  • 作者简介:李 倩（1990-）,女,四川西昌人,硕士研究生,护师。
  • 基金资助:
    泸州市科技计划创新苗子项目（2018-RCM-67）

Effects of Maternal Heart Sound Combined with Voice Stimulation on Heart Rate and Behavior Status of Premature Infants in NICU

LI Qian1, TU Su-hua2, LI Yu-xin3, TAN Lin3, LUO Shan3, CHEN Li3   

  1. 1. Neonatal Diagnosis and Treatment Center, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Healthand Disorders,China International Science and Technology Cooperation Base of Child Development and Critical Disorders,Chongqing 400014, China;
    2. Dept. of Obstetrics and Gynecology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China;
    3. School of Nursing, Southwest Medical University,Luzhou 646000, China
  • Received:2019-04-04 Published:2020-07-27

PDF (PC)

471

赞

摘要： 目的 探讨母亲心音联合话音刺激与音乐疗法2种听觉刺激方式对NICU早产儿心率及行为状态的影响。方法 选取符合纳入排除标准的早产儿90例,按随机化数字表分为对照组、2个干预组（音乐疗法组和母亲声音刺激组）,每组各30例。对照组行常规护理,音乐疗法组在常规护理的基础上播放音乐,母亲声音刺激组在常规护理的基础上播放母亲心音联合话音的声音刺激,2次/d,持续14 d。比较3组早产儿在干预前1 min,干预中（10 min、20 min）,干预后1 min的心率及行为状态情况。结果 （1）组间比较：干预前1 min 3组早产儿心率及行为状态评分差异无统计学意义（P>0.05）;干预中（10 min、20 min）和干预后1 min 2个干预组心率及行为状态评分均低于对照组（P<0.05）;干预中20 min及干预后1 min母亲声音刺激组心率及行为状态评分显著低于音乐疗法组（P<0.05）,但干预中10 min 2个干预组心率及行为状态评分差异无统计学意义（P>0.05）,干预后1 min 2个干预组间行为状态差异无统计学意义（P>0.05）;（2）组内比较：对照组干预前中后4个时间点间心率及行为状态评分差异无统计学意义（P>0.05）,2个干预组于干预中（10 min、20 min）及干预后1 min的心率及行为状态评分显著低于干预前1 min（P<0.05）,但母亲声音刺激组干预中20 min与干预后1 min间行为状态评分差异无统计学意义（P>0.05）。结论 母亲心音联合话音刺激与音乐疗法相比,能更有效的降低早产儿心率,稳定情绪,促进睡眠,达到最佳行为状态。

关键词: 早产儿, 母亲声音刺激, 音乐疗法, 心率, 行为状态

Abstract: Objective To investigate the effects of maternal heart sound combined with voice stimulation and music therapy on heart rate and behavior of premature infants in NICU. Methods Ninety premature infants who met the exclusion criteria were randomly divided into control group, group B (music therapy group) and group C (maternal voice stimulation group), with 30 cases in each group. Control group received routine nursing; group B played music on the basis of routine nursing, and group C played sound stimulation of mother's heart sound combined with voice on the basis of routine nursing. The intervention performed twice a day for 14 days. Heart rate and behavioral status of premature infants 1min before the intervention, during the intervention (10min,20min) and 1min after the intervention were compared among the three groups. Results (1)inter-group comparison showed there was no significant difference in heart rate and behavior status score of premature infants among the three groups 1min before the intervention (P>0.05) but during the intervention (10min, 20min) and 1min after the intervention, the scores of heart rate and behavior state of group B and group C were lower than those in control group (P<0.05). The heart rate and behavioral status score at 20min of the intervention and 1min after the intervention, in group C were significantly lower than those in group B (P<0.05), but there was no significant difference in heart rate and behavioral state score at 10min of the intervention between these two groups (P>0.05). There was no significant difference in behavioral status between these two groups 1 min after the intervention (P>0.05). (2)Intra-group comparison showed that there was no significant difference in heart rate and behavior status score in control group before and after the intervention (P>0.05); during the intervention (10min, 20min) and 1min after intervention, heart rate and behavioral status scores in group B and group C were significantly lower than those 1min before the intervention (P<0.05), but there was no significant difference in behavior status score of group C at 20min of the intervention and 1min after the intervention (P>0.05). Conclusion Compared with music therapy, maternal heart sound combined with voice stimulation can effectively reduce the heart rate of premature infants, stabilize mood, promote sleep, and achieve the best behavior state.

Key words: premature infant, maternal sound stimulation, music therapy, heart rate, behavioral state

中图分类号: 

  • R473.72
[1] Valizadeh S, Bagher H M, Alavi N, et al.Assessment of Sound Levels in a Neonatal Intensive Care Unit in Alzahra Teaching Hospital in Tabriz, Iran[J]. J Caring Sci, 2013, 2(1):19-26.DOI:10.5681/jcs.2013.003.
[2] 瞿彭亚男,张军,范湘鸿.早产儿母亲心理健康问题及干预研究进展[J].护理学杂志,2017,32(12):102-105.DOI;10.3870/j.issn.1001-4152.2017.12.102.
[3] 李琴. 光暗循环对早产儿生长发育的影响研究[D].苏州:苏州大学,2017:19.
[4] 李凤妮,李小容,李宁,等.母亲声音刺激在早产儿护理中的研究进展[J].护理学杂志,2016,31(15):97-100.DOI:10.3870/j.issn.1001-4152.2016.15.097.
[5] 陈妍君,谷瑞芮,李杨.母亲声音在新生儿重症监护病房早产儿中应用效果的Meta分析[J].解放军护理杂志,2019,36(1):26-31.DOI:10.3969/j.issn.1008-9993.2018.21.00.
[6] 陈妍君,李杨.母亲声音缓解新生儿操作性疼痛的干预研究进展[J].护理学报,2018,25(11):17-20.DOI:10.16460/j.issn1008-9969.2018.11.017.
[7] Pino O.Fetal Memory:The Effects of Prenatal Auditory Experience on Human Development[J]. Bao J Med Nursing, 2016, 2(4):20. DOI:10.24947/baojmn/2/2/120.
[8] Gerhardt K J, Abrams R M.Fetal Exposures to Sound and Vibroacoustic Stimulation[J]. J Perinatol, 2000, 20(S1):21-30.DOI:10.1038/sj.jp.7200446.
[9] Health C E.Noise: A Hazard for the Fetus and Newborn[J]. Pediatrics,1997,100(4):724-727.DOI:10.1542/peds.100.4.724.
[10] Stouffer J W, Shirk B J, Polomano R C.Practice Guidelines for Music Interventions with Hospitalized Pediatric Patients[J]. J Pediatr Nurs, 2007, 22(6):448-456.DOI:10.1016/j.pedn.2007.04.011.
[11] 李凤妮. 母亲声音刺激与口腔运动干预对早产儿经口喂养、心率及行为状态的效果研究[D].南宁:广西医科大学,2016.
[12] Anderson G C, Behnke M, Gill N E, et al.Self-regulatory Gavage to Bottle Feeding for Preterm Infants: Effect on Behavioral State, Energy Expenditure, and Weight Gain[M]. New York: Springer, 1990:83-97.
[13] 许美丽. 音乐疗法缓解早产儿视网膜病变检查疼痛效果的研究[D].天津:天津中医药大学,2015.
[14] Pierre K, Claire Z, Claire L, et al.Moderate Acoustic Changes Can Disrupt the Sleep of Very Preterm Infants in Their Incubators[J]. Acta Paediatr, 2013, 102(10):949-954.DOI:10.1111/apa.12330.
[15] Gooding L F, MT B C.Using Music Therapy Protocols in the Treatment of Premature Infants: An Introduction to Eurrent Practices[J]. Arts Psychother, 2010, 37(3):211-214.DOI:10.1016/j.aip.2010.04.003.
[16] Arnon S, Shapsa A, Forman L, et al.Live Music is Beneficial to Preterm Infants in the Neonatal Intensive Care Unit Environment[J]. Birth, 2010, 33(2):131-136.DOI:10.1111/j.0730-7659.2006.00090.x.
[17] Filippa M, Devouche E, Arioni C, et al.Live Maternal Speech and Singing Have Beneficial Effects on Hospitalized Preterm Infants[J]. Acta Paediatr, 2013, 102(10): 1017-1020.DOI:10.1111/apa.12356.
[18] Voegtline K M, Costigan K A, Pater H A, et al.Near-term Fetal Response to Maternal Spoken Voice[J]. Infant Behav Dev,2013,36(4):526-533.DOI:10.1016/j.infbeh.2013.05.002.
[19] Joanne L, Kristen S, Ann-marie D, et al. The Effects of Music Therapy on Vital Signs, Feeding, and Sleep in Premature Infants[J]. Pediatrics, 2013, 131(5):902-918.DOI:10.1542/peds.2012-1367.
[20] 郭莉. 不同新生儿重症监护室(NICU)环境对早产儿生理反应和应激性激素的影响[D].青岛:青岛大学, 2003.DOI:10.7666/d.y522541.
[21] 夏冬晴,陈梦莹,闵翠婷,等.早期反复操作性疼痛对足月新生儿疼痛反应的影响[J].中华实用儿科临床杂志,2016,31(9):692-695.DOI:10.3760/cma.j.issn.2095-428X.2016.09.013.
[22] 安昱,余丽君,郭凤娟.声音干预及α脑波音乐对早产儿生长发育的影响[J].护理研究,2014,28(7A):2363-2364.DOI:10.3969/j.issn.10096493.2014.19.025.
[23] Webb A R, Heller H T, Benson C B, et al.Mother's Voice and Heartbeat Sounds Elicit Auditory Plasticity in the Human Brain before Full Gestation[J]. Proc Natl Acad Sci USA, 2015, 12(10):3152-3157. DOI:10.1073/pnas.1414924112.
[24] 廖金花,苏丽静,侯婉玲,等.非药物干预对新生儿重症监护室早产儿睡眠影响的Meta分析[J].循证医学, 2018,18(3):150-159.DOI:10.12019/j.issn.1671-5144.2018.03.007.
[25] 施子霞. 音乐疗法对新生儿重症监护室内早产儿的应用价值及对患儿睡眠质量的影响[J]. 世界睡眠医学杂志,2018, 5(8):930-932.DOI:10.3969/j.issn.2095-7130.2018.08.020.
[26] 李凤妮,李小容,韦琴,等.母亲声音刺激对早产儿心率和行为状态的影响[J].护理学杂志,2016,31(7):20-22.DOI:10.3870/j.issn.1001-4152.2016.07.020.
[27] Jardri R, Houfflin-debarge V, Delion P, et al. Assessing Fetal Response to Maternal Speech Using a Noninvasive Functional Brain Imaging Technique[J]. Int J Dev Neurosci, 2012, 30(2):159-161.DOI:10.1016/j.ijdevneu.2011.11.002.
[28] 李月梅. 非营养性吸吮对早产低出生体重儿生长发育的影响研究[D].天津:天津医科大学,2017:12.
[1] 刘莉, 于卫华, 肖娟, 汪阿慧, 凌雅. 便利蜷曲联合甜味剂棉签减轻早产儿气管内吸痰疼痛的效果研究[J]. 护理学报, 2024, 31(9): 10-14.
[2] 纪锐婷, 林丹娜, 刘小成, 李婷婷, 谢映梅, 胡冰, 应文娟. 早产儿初乳口腔免疫疗法的最佳证据总结[J]. 护理学报, 2024, 31(8): 37-42.
[3] 江艳, 唐文娟, 赵海燕, 范巧玲. 新生儿营养风险筛查工具的研究进展[J]. 护理学报, 2024, 31(22): 26-29.
[4] 魏海霞, 谢小敏, 马姣媚, 李国曦, 罗燕, 江逊. 四步高位灌肠法对早产儿胎粪排出延迟的效果观察[J]. 护理学报, 2024, 31(17): 69-72.
[5] 雷青, 雷小平, 佘桂芳, 李娜, 王娅鑫, 孙鸿燕. NICU中住院早产儿多感官刺激的最佳证据总结[J]. 护理学报, 2024, 31(10): 48-52.
[6] 郑思琪, 陈璐, 马晴, 王钰涵, 成杰, 王云龙. 双耳节拍音乐疗法对脑卒中偏瘫患者焦虑抑郁及疲劳的效果研究[J]. 护理学报, 2023, 30(5): 72-78.
[7] 王帆, 崔慧敏, 李胜玲, 丁晓华, 王晓燕, 段小凤. 基于循证构建NICU护士主导早产儿出院计划核心能力指标体系[J]. 护理学报, 2023, 30(17): 73-78.
[8] 段淑女, 李敏敏, 司在霞. 灌肠促进早产儿胎便排出的应用研究进展[J]. 护理学报, 2023, 30(16): 47-50.
[9] 罗爽, 尹华英, 雷莉, 王海梅. 父亲抑郁情绪和家庭功能在早产儿母亲抑郁情绪与母婴情感联结间的中介效应[J]. 护理学报, 2022, 29(9): 58-63.
[10] 曹咪, 张军, 岳少婷. 早产儿出院后神经发育支持性照护的最佳证据总结[J]. 护理学报, 2022, 29(6): 44-49.
[11] 郑丹丹, 任静, 李艳, 徐倩. 母亲感知育儿自我效能量表的汉化及其在早产儿母亲中的信效度研究[J]. 护理学报, 2021, 28(9): 54-57.
[12] 李文辉. 1例早产儿坏死性小肠结肠炎并肠穿孔行造瘘术后的护理[J]. 护理学报, 2021, 28(9): 74-75.
[13] 郭跃华, 党雁, 章朋, 刘姝. 6例高位小肠坏死早产儿Bishop-Koop肠造口术后护理[J]. 护理学报, 2021, 28(5): 59-61.
[14] 杨茹, 黄霖霖, 彭文涛. 基于Web of Science早产儿追赶生长研究热点前沿可视化分析[J]. 护理学报, 2021, 28(18): 17-21.
[15] 王茹霞, 陈京立. 我国早产儿护理文献研究热点分析[J]. 护理学报, 2020, 27(16): 25-27.
Viewed
Full text


Abstract

Cited
  Shared   
No Suggested Reading articles found!