产前吸奶器干预泌乳对产后母乳喂养质量的影响  

Effect of prenatal intervention with breast pump on the quality to postpartum breast-feeding

作　　者：张惠[1] 栾俊 李艳[1] 霍杉杉 窦娜[1] Zhang Hui;Luan Jun;Li Yan;Huo Shanshan;Dou Na(Obstetrics Ward,Faculty of Obstetrics and Gynecology,First Medical Center,the Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心妇产科医学部产科病区,北京100853

出　　处：《发育医学电子杂志》2023年第1期25-31,共7页Journal of Developmental Medicine (Electronic Version)

基　　金：国家重点研发计划(2021YFC1005302);解放军总医院护理部课题(2019YH08)。

摘　　要：目的探讨产前吸奶器干预泌乳的可行性以及对产后母乳喂养质量的影响。方法选取2019年5月至2021年5月在解放军总医院第一医学中心产科病区住院的90例足月妊娠孕妇为研究对象,按照随机数字表法将其分为研究组(n=45)与对照组(n=45)。对照组仅接受常规母乳喂养护理措施,研究组在常规母乳喂养护理措施的基础上,由研究小组人员每日上、下午在电子胎心监护的条件下,用吸奶器的按摩模式干预泌乳20 min。比较两组分娩结局和母乳喂养质量等方面的差异。统计学方法采用t检验、秩和检验、χ^(2)检验或Fisher确切概率法、趋势性χ^(2)检验和Pearson相关性分析。结果两组孕妇分娩结局比较,差异均无统计学意义(P值均>0.05)。两组产妇产后6 h有泌乳的比例比较,差异无统计学意义(P>0.05)。研究组与对照组比较,产后第3天泌乳充足的比例[86.0%(37/43)与64.3%(27/42),χ^(2)=4.435,P=0.035],出院时母乳喂养满意度[10(9,10)与9(8,10)分,Z=-0.222,P=0.026],研究组均高于对照组,且差异均有统计学意义。两组新生儿出生第3天体质量下降>7%的比例比较,差异无统计学意义(P>0.05)。研究组新生儿出生第3天经皮胆红素值低于对照组[(168±37)与(190±34)μmol/L,t=-2.833,P=0.006],大便颜色转黄比例高于对照组[95.3%(41/43)与78.6%(33/42),χ^(2)=5.308,P=0.021],添加配方奶次数少于对照组[0(0,2)与0(0,5)次,Z=-2.178,P=0.029],6个月纯母乳喂养比例高于对照组[95.3%(41/43)与78.6%(33/42),χ^(2)=5.308,P=0.021],差异均有统计学意义。此外,随干预次数增加,出生第3天添加配方奶次数呈下降趋势(χ^(2)=12.481,P<0.001;r=-0.308,P<0.001),经皮胆红素值呈下降趋势(χ^(2)=7.230,P=0.007;r=-0.293,P=0.006),产后第3天泌乳充足率呈上升趋势(χ^(2)=5.121,P=0.024;r=0.247,P=0.023),出生6个月纯母乳喂养率呈上升趋势(χ^(2)=3.866,P=0.049;r=0.215,P=0.049)。结论足月妊娠孕妇临产前使用吸奶器进行Objective To explore the feasibility of prenatal breast pump intervention in lactation and the effect on the quality of postpartum breast-feeding.Method A total of 90 full-term pregnant women hospitalized in the Obstetrics Ward,First Medical Center,the Chinese PLA General Hospital from May 2019 to May 2021 were selected as the research objects,and divided into study group(n=45)and control group(n=45)according to random number table method.The control group was only received usual breast-feeding nursing measures.For the study group,on the basis of routine breast-feeding nursing measures,the research team intervened lactation for 20 minutes with the massage mode of breast pump in the morning and afternoon every day under the condition of electronic fetal monitoring.The outcomes of delivery and quality of breast-feeding were compared between the two groups.Statistical methods performed by t test,rank sum test,χ^(2)test or Fisher exact probability method,trendχ^(2)test and Pearson correlation analysis.Result There was no significant difference in delivery outcome between the two groups(all P>0.05).There was no significant difference in the proportion of lactation at 6 h postpartum between the two groups(P>0.05).The proportion of adequate lactation on the 3rd day after delivery[86.0%(37/43)vs 64.3%(27/42),χ^(2)=4.435,P=0.035]and the satisfaction of breast-feeding at discharge[10(9,10)vs 9(8,10)points,Z=-0.222,P=0.026]in the study group were higher than those in the control group,and the differences were statistically significant.There was no significant difference between the two groups in proportion of the decrease for the 3rd day celestial body mass>7%(P>0.05).The value of transcutaneous bilirubin in the study group was lower than that in the control group at the 3rd day of birth[(168±37)vs(190±34)μmol/L,t=-2.833,P=0.006],and the proportion of stool color turning yellow was higher than that in the control group[95.3%(41/43)vs 78.6%(33/42),χ^(2)=5.308,P=0.021],the number of adding formula milk was less than th

关 键 词：足月妊娠 孕妇 产前干预泌乳 母乳喂养质量 纯母乳喂养 经皮胆红素 

分 类 号：R473.71[医药卫生—护理学]