批判性回顾和总结有关新生儿禁欲综合征(NAS)新生儿评估的最新知识。
我们在以下数据库中搜索了2014年1月至2020年6月之间以英文发表的有关NAS新生儿评估的文章:PubMed,CINAHL,和PsycINFO。关键词和医学主题用于识别相关研究文章的标题术语包括新生儿禁欲综合征;Finnegan量表;吃,睡眠,控制台;表观遗传学;遗传学;药代动力学;和测量。我们独立审查了纳入的文章。
我们通过数据库搜索检索了435篇文章,通过手动参考搜索检索了17篇;最终评论中包含了31篇文章。排除的文章是重复的,与NAS无关,定性研究,和/或低质量。
我们使用Whittemore和Knafl的方法来指导这一综合评论。我们在以下标题下提取和组织数据:作者,年和国家,目的,研究设计,参与者,测量,生物标志物(如果适用),结果,局限性,recommendations,和干预。
Finnegan新生儿禁欲量表是测量新生儿NAS症状最广泛使用的工具,虽然很主观。最近,从Finnegan新生儿禁欲量表过渡到饮食,睡眠,控制台方法,这包括结构化评估和干预,并已被证明可以减少住院时间和总阿片类药物治疗剂量。研究人员检查了NAS的生物标志物,包括遗传标记和自主神经系统反应,关于NAS发生率和不同严重程度的变化。在包含的文章中,在怀孕期间接受纳曲酮治疗的患有阿片类药物使用障碍的女性分娩的新生儿没有NAS诊断.然而,大多数接受丁丙诺啡治疗的妇女分娩的新生儿诊断为NAS.
NAS以多种方式对新生儿产生负面影响,对新生儿戒断反应的客观评估和测量仍未得到充分研究,需要进一步调查。
To critically
review and summarize current knowledge regarding the assessment of newborns with neonatal abstinence syndrome (NAS).
We searched the following databases for articles on the assessment of newborns with NAS that were published in English between January 2014 and June 2020: PubMed, CINAHL, and PsycINFO. Keywords and Medical Subject Heading terms used to identify relevant research articles included neonatal abstinence syndrome; Finnegan Scale;
eat, sleep, console; epigenetics; genetics; pharmacokinetics; and measurement. We independently reviewed articles for inclusion.
We retrieved 435 articles through database searches and 17 through manual reference searches; 31 articles are included in the final
review. Excluded articles were duplicates, not relevant to NAS, qualitative studies, and/or of low quality.
We used the methodology of Whittemore and Knafl to guide this integrative
review. We extracted and organized data under the following headings: author, year and country, purpose, study design, participants, measurement, biomarker (if applicable), results, limitations, recommendations, and intervention.
The Finnegan Neonatal Abstinence Scale is the most widely used instrument to measure symptoms of NAS in newborns, although it is very subjective. Recently, there has been a transition from the Finnegan Neonatal Abstinence Scale to the
eat, sleep, console method, which consists of structured assessment and intervention and has been shown to decrease length of hospital stay and total opioid treatment dose. Researchers examined biomarkers of NAS, including genetic markers and autonomic nervous system responses, on the variation in incidence and differential severity of NAS. In the included articles, women with opioid use disorder who were treated with naltrexone during pregnancy gave birth to newborns without NAS diagnoses. However, most women who were treated with buprenorphine gave birth to newborns with NAS diagnoses.
NAS negatively affects newborns in a multitude of ways, and the objective assessment and measurement of the newborn\'s response to withdrawal remains understudied and needs further investigation.