喂养与生育力的探讨  

Menses Return and the Type of Breast -- Feeding

作　　者：金碧华[1] 姜国珠[1] 潘琢如[1] 杨淑蓉[2] 虞菏莲 张逸[1] 

机构地区：[1]上海第二医科大学新华医院妇产科,上海200092 [2]上海第二医科大学新华医院核医学科,上海200092

出　　处：《上海第二医科大学学报》2000年第2期125-128,共4页Acta Universitatis Medicinalis Secondae Shanghai

基　　金：川同学会科研启动基金

摘　　要：目的研究哺乳期妇女不同喂养方式的生育力恢复。方法　１０４　例对象分为母乳、混合、人工喂养三组，观察和记录宫颈粘液，其中３３例连续测定了血生乳素和雌二醇。３２例测定了尿雌激素和（或）孕二醇。结果　产后第１次来经的平均日三组分别为１９８．１６、 １７５．３５和９１．４４ｄ，第２次与第１次月经间隔的平均日三组分别为６７．５０、２８．５７和２３．２８ｄ，经统计分析，母乳、混合与人工喂养组之间都有显著差异（Ｐ＜０．０５）。宫颈粘液法估计月经恢复的正确性为８６．５３％，血生乳素和雌二醇的比例预测月经恢复的灵敏度达９３．２４％、特异性为８９．２８％，１２例混合喂养者尿孕二醇水平均＜７．１０μｍｏｌ／２４ｈ，表明无排卵发生。结论　应用宫颈粘液观察法了解生育力简单、正确，妇女自己能掌握，可推广。遇到识别粘液有困难时，作内分泌测定，可了解生育力的恢复。Objective Menses return of breast-- feeding mothers was studied prospectively. Methods Cervical mucus was observed and monitored in 104 breast-feeding mothers, and serum prolactin and estradiol were measured in 33 breast -- feeding mothers. Urine estrogen and/or pregnanediol were measured in 32 breast-- feeding mothers. Results It showed that the average periods of the first bleeding after cessation of lochia were 198.16, 175.35 and 91.44 days respectively. It was significant between breast-- feeding and bottle -- feeding group statistically (P<0.05). About the type of menses, the incidence of short luteal phase and non -- fertile mucus before the first bleeding in the breast-- feeding group were higher than those of the bottle -- feeding group. It was 17.33 % .3.57% and 18.66%:3.57 %. It also was significant statistically (P<0.05). Menses return was well-- estimated by 0.30 ratio of serum prolactin and estradiol. Sensitivity was 93.24%, and specificity 89.28%. The level of urine estrogen was 112.00nmol/24h in fully breast -- feeding group; 134.05nmol/24h in partially breast-- feeding group; and 192.30nmol/24h (peak level) in bottle-- feeding group. The pregnanediol levels confirming ovulation in bottle -- feeding group were 7umol/24h and 9 umol/24h respectively. The level of pregnanediol was only 4.4pmol/24h in one mother of bottle-- feeding group. It indicated that she didn't ovulate at that cycle. Conclusion Observation of cervical mucus is a simple, scientific and reliable method to estimate the menses return of breast-feeding mothers and can be accepted by breast -- feeding mothers. If it could be combined with the measurement of serum prolactin/estradiol and with the measurement of urine estrogen and/or pregnanediol, the date of menses return or ovulation would be determined certainly.

关 键 词：哺乳期 喂养 生育力 

分 类 号：R174.4[医药卫生—妇幼卫生保健]