哺乳期急性乳腺炎四级预防方案的可行性  

Feasibility of four grades prevention strategy for acute mastitis during lactation

作　　者：马祥君[1] 汪洁[1] 孔令伟[1] 高雅军[1] 何湘萍[1] 高海凤[1] 谢祥[1] 

机构地区：[1]北京市海淀妇幼保健院乳腺病防治中心,100080

出　　处：《中国妇幼保健》2010年第17期2335-2338,共4页Maternal and Child Health Care of China

摘　　要：目的:探讨哺乳期急性乳腺炎不同阶段的最佳治疗方法及四级预防方案的可行性。方法:0级预防是通过指导围产期母乳喂养,防止发生乳头皲裂和乳汁淤积;1级预防是在乳汁淤积期,采用"理疗+乳腺按摩+电动奶泵吸奶"三联治疗,防止进展为哺乳期急性乳腺炎的急性炎症期;2级预防是在哺乳期急性乳腺炎的急性炎症期采用"理疗+乳腺按摩+电动奶泵吸奶+敏感抗生素治疗"四联疗法,防止形成乳腺脓肿;3级预防是指在乳腺脓肿期,采用微创治疗方法,最大限度保留母乳喂养功能。结果:0级预防:研究组病变发生率为16%,对照组32%(P<0.05);1级预防:研究组治疗总有效率91.8%;对照组总有效率65.1%(P<0.01)。2级预防:"理疗+乳腺按摩+电动奶泵吸奶+敏感抗生素治疗"的四联疗法效果最好;3级预防:穿刺抽脓和置管冲洗引流是乳腺脓肿有效的微创治疗方法。结论:哺乳期急性乳腺炎四级预防方案可以指导临床在哺乳期急性乳腺炎的不同阶段采用有针对性的预防和治疗措施,防止病情向下一阶段发展,最大限度减轻病人的痛苦和保留母乳喂养功能。Objective： To explore the ideal therapy of acute mastitis during lactation at different stages and feasibility of four grades prevention strategy. Methods： Four grades prevention strategy included： 0 grade prevention： preventing cracked nipple and galactostasis by directing perinatal breast feeding; 1 grade prevention： adopting triple therapeutic combination of physical treatment,massage and electronic absorption pump in order to prevent the progress of acute inflammation; 2 grade prevention： adopting tetra-therapeutic combination of physical treatment,massage,electronic absorption pump and sensitive antibiotics in order to prevent the progress of mammary abscess; 3 grade prevention： adopting minimally invasive surgery for mammary abscess in order to reserve breast feeding function. Results： 0 grade preven- tion： the incidences of disease in study group and control group were 16% and 32% ,respectively,there was significant difference （ P 0. 05） ; 1 grade prevention： the total effective rates of study group and control group were 91. 8% and 65. 1% ,respectively,there was sig- nificant difference （ P 0. 01） ; 2 grade prevention： the therapeutic effect of tetra - therapeutic combination of physical treatment,massage, electronic absorption pump and sensitive antibiotics was the best; 3 grade prevention： puncturation and drainage were effective and minimally invasive in treatment of mammary abscess. Conclusion： Four grades prevention strategy can direct specific prevention and treatment of acute mastitis during lactation at different stages in clinic,prevent the progress of the disease,relieve the pain of patients and reserve breast feed- ing function furthest.

关 键 词：急性乳腺炎 哺乳期 微创治疗 母乳喂养 

分 类 号：R173[医药卫生—妇幼卫生保健]