产褥期乳腺炎影响因素分析  

Analysis of influencing factors of puerperal mastitis

作　　者：廖莎 黄燕[2] 邓媛 Liao Sha;Huang Yan;Deng Yuan(West China School of Nursing,Sichuan University/Department of Operating Room,West China Second University Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China;Department of Nursing,West China Second University Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China;Department of Breast,Chengdu Women′s and Children′s Central Hospital·School of Medicine,University of Electronic Science and Technology of China,Chengdu 610073,Sichuan Province,China)

机构地区：[1]四川大学华西护理学院/四川大学华西第二医院手术室,成都610041 [2]四川大学华西第二医院护理部,610041 [3]电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院乳腺科,610073

出　　处：《中华妇幼临床医学杂志（电子版）》2021年第6期715-725,共11页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：四川省卫健委医学科技项目(21PJ134)。

摘　　要：目的探讨导致产妇发生产褥期乳腺炎(PM)的影响因素。方法选择2020年9月1日至12月31日,在成都市某三甲妇女儿童医院分娩,并进行产后42 d随访的1162例产妇为研究对象。根据产妇产后42 d内是否发生PM,将其分为PM组(n=103)与对照组(n=1059)。采用本研究自行设计的《产褥期乳腺炎相关影响因素调查问卷》(以下简称为《调查问卷》),联合《中国简式心理状态剖面图(POMS)量表》(以下简称为《POMS量表》),分别对2组产妇进行调查。《调查问卷》内容主要包括产妇一般人口学资料、妊娠及疾病、药物使用、母乳喂养、饮食及生活习惯等10个维度,共计50个条目。《POMS量表》包括心理焦虑等7个维度,共计40个条目。对2组产妇《调查问卷》条目及《POMS量表》评分,采用独立样本t检验、χ^(2)检验及Fisher确切概率法等进行统计学比较。本研究遵循的程序符合病例收集医院医学伦理委员会要求,经过该伦理委员会批准[审批文号:科研伦审2021(29)],并与研究对象签署临床研究知情同意书。2组产妇的年龄等一般临床资料比较,差异无统计学意义(P>0.05)。结果①本研究纳入产妇的PM发生率为8.9%(103/1162),产后第3、4周PM发生率最高,分别为2.7%(31/1162)与2.4%(28/1162)。②本研究2组产妇围生期补充铁剂及口服益生菌占比,乳头皲裂程度、吸奶器使用时间及频率、乳头保护罩与乳头保护霜使用频率构成比,哺乳衔接姿势正确率,哺乳时乳房疼痛程度、哺乳内衣穿戴率等分别比较,差异均有统计学意义(P<0.05)。③PM组产妇《POMS量表》焦虑评分为(7.1±5.0)分,显著高于对照组的(5.3±4.1)分,并且差异有统计学意义(t=-3.540、P=0.001)。④将上述影响产妇发生PM的单因素分析中差异有统计学意义因素,并结合已有研究结果与临床经验,纳入10项影响因素,进行多因素非条件logistic回归分析结果显示,产妇围生期补充铁Objective To explore influencing factors of puerperal mastitis(PM)in puerperae.Methods A total of 1162 puerperae who gave birth in a tertiary hospital for women and children in Chengdu from September 1 to December 31,2020 and were followed up for 42 days after delivery were selected as research subjects.According to occurrence of PM within 42 days after delivery or not,they were divided into PM group(n=103)and control group(n=1059).Self-designed Questionnaire on Influencing Factors of Postpartum Mastitis(hereinafter referred to as the Questionnaire),and Chinese Simple Profile of Mood States(POMS)Scale(hereinafter referred to as the POMS Scale)were used for investigation in two groups.The Questionnaire mainly included 50 items in 10 dimensions:general demographic data,pregnancy and disease,perinatal drug use,breastfeeding,diet and living habits,and so on.The POMS Scale included 40 items in 7 dimensions of anxiety and so on.Items in the Questionnaire and scores of POMS Scale were compared between two groups by independent-samples t test,chi-square test and Fisher′s exact test.The procedures followed in this study complied with requirements of the Medical Ethics Committee of cases collected hospital,and was approved by its Ethics Committee[Approval No.2021(29)of Scientific Research Review],and each subject signed an informed consent form for clinical research.There were no significant differences in general clinical data between two groups,such as maternal age,and so on(P>0.05).Results①The incidence of PM in puerperae included in this research was 8.9%(103/1162),and incidences of PM in the 3rd and 4th weeks after delivery were the highest as 2.7%(31/1162)and 2.4%(28/1162),respectively.②Proportion of iron supplementation and oral probiotics during perinatal period,constituent ratio of cracked nipple degree,time and frequency of using breast pump,frequency of using nipple shield and nipple protection cream,rate of correct breastfeeding connection posture,degree of breast pain during breastfeeding,and composition

关 键 词：产褥期感染 乳腺炎 母乳喂养 影响因素 生活方式 焦虑 产妇 

分 类 号：R47[医药卫生—护理学]