林火仙

【摘要】 目的：针对婴幼儿的痛觉特点及心理特征，在静脉穿刺时实施舒适护理，降低患儿的疼痛感，减轻因穿刺疼痛而造成的恐惧感，提高静脉穿刺成功率。方法：选取2018年6-9月在笔者所在科室进行首次静脉输液的患儿共300例，随机分为对照组和观察组，各150例。两组在静脉穿刺过程中均进行常规护理，观察组在此基础上给予舒适护理，即在进行静脉穿刺时利用安慰奶嘴转移注意力法和玩具、音乐、视频转移注意力法，比较两组患儿疼痛强度、恐惧程度表现及一次穿刺成功率。结果：观察组一次穿刺成功率高于对照组，而恐惧程度及疼痛强度均低于对照组，差异均有统计学意义（P<0.05）。结论：婴幼儿在静脉穿刺时予舒适护理能显著降低穿刺时的疼痛感，减轻因穿刺疼痛而造成的恐惧感，提高静脉穿刺成功率。

【关键词】 舒适护理 婴幼儿 静脉穿刺 疼痛

doi：10.14033/j.cnki.cfmr.2019.29.040 文献标识码 B 文章编号 1674-6805（2019）29-00-03

[Abstract] Objective： To improve the success rate of vein puncture， which can reduce pain and fear during venipuncture in infants according to their pain characteristics and psychological characteristics. Method： Three hundred children underwent the first intravenous infusion in the authors department from June to September 2018 were prospectively studied. The infants were randomly divided into the control group and the experimental group. Routine care was given in the control group， while comfortable nursing was given in the experimental group. The success rate of venipuncture were analyzed， and scored the degree of fear and pain were analyzed in the each group. Result： The success rate of one puncture in the observation group was higher than that in the control group， but the degree of fear and pain intensity in the observation group were lower than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： Comfortable nursing care for infants and young children during venipuncture can significantly reduce the pain during puncture， reduce the fear caused by puncture pain， and improve the success rate of venipuncture.

[Key words] Comfortable nursing Infant Venipuncture Pain

First-authors address： Sanming First Hospital Affiliated to Fujian Medical University， Sanming 365000， China

随着医学模式的转变，1995年Kolcada提出了舒适护理理论的概念[1]。由于该理论更加关注患者的舒适感受，使得舒适护理逐渐成为一种全新的护理模式，对于促进和改善护理工作具有重要意义。静脉穿刺是儿科护理工作中不可缺少的一项基本技术操作，是保障临床治疗用药的重要手段，也是造成家属不满意或者暴力伤医事件的重要原因。但是由于婴幼儿年龄小，血管细，好动不配合或家属迫切希望一针见血给予穿刺者施压等原因，常常导致穿刺失败。而反复静脉穿刺及长时间强迫性的肢体固定容易造成患儿对静脉穿刺极度恐惧。为了能够有效提高静脉穿刺的成功率，减轻患儿因穿刺疼痛或被迫体位而造成的恐惧感，在临床实践中，笔者发现针对婴幼儿痛觉特点，静脉穿刺时予舒适护理能降低穿刺时的疼痛感，减轻因穿刺疼痛而造成的恐惧感，提高静脉穿刺成功率，具体报告如下。……