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目的观察产后早期乳房刺激、仿制婴儿哺乳情景进行人工吸吮结合食疗等措施对早产儿产妇泌乳、母乳喂养率、早产儿肠道不耐受发生率以及母婴健康的影响。方法在不同级别医院分娩的早产儿产妇(母婴分离)786例,随机分为治疗组和对照组各393例。对照组:给予产后常规饮食和康复指导,讲解母婴分离后保持泌乳的方法;治疗组:在对照组基础上,从产后6 h由经过培训的专科护士进行穴位刺激、乳房护理,仿制婴儿哺乳情景进行人工吸吮以及结合食疗等措施。结果治疗组早产儿产妇泌乳始动时间明显早于对照组,差异有显著统计学意义(P<0.01);治疗组产妇干预后血清泌乳素(PRL)水平明显高于对照组,差异有显著统计学意义(P<0.01);治疗组产后42 d泌乳量、纯母乳喂养率、子宫复旧良好率、早产儿肠道不耐受发生率、体重增长状况明显优于对照组,差异有显著统计学意义(P<0.01)。而两组产妇乳腺炎的发生率、体内雌二醇(E2)水平干预前、干预后比较差异均无统计学意义(P>0.05)。结论产后早期乳房刺激、仿制婴儿哺乳情景人工吸吮以及结合食疗等措施,能够促进早产儿产妇泌乳,提高母乳喂养率,降低早产儿肠道不耐受发生率,有利于早产儿生长发育,对母婴健康有重要意义。
Objective To observe the effects of early postpartum breast stimulation, artificial infant suckling and artificial feeding on the lactation, breastfeeding rate, the incidence of intestinal intolerance in preterm infants and maternal and infant health. Methods 786 pregnant women (separated from mother and child) of preterm infants delivered at different levels of hospitals were randomly divided into treatment group and control group with 393 cases each. Control group: given postpartum diet and rehabilitation guidance, to explain the method of keeping mother and child separated after lactation; treatment group: on the basis of the control group, 6 hours postpartum by trained specialist nurses acupoint stimulation, breast care, imitation of infant breastfeeding Scenarios for artificial sucking and diet combined with other measures. Results The onset time of lactation in preterm infants in treatment group was significantly earlier than that in control group, and the difference was statistically significant (P <0.01). The level of serum prolactin (PRL) in treatment group was significantly higher than that in control group (P <0.01). The milk yield, exclusive breastfeeding rate, good rate of uterine involution, the incidence of intestinal intolerance and weight gain in the treatment group at 42 d postpartum were significantly better than those in the control group, the difference was statistically significant Significance (P <0.01). The incidence of maternal mastitis and the level of E2 in the two groups before intervention were not significantly different after intervention (P> 0.05). Conclusions Early postpartum breast stimulation, artificial infant suckling in imitation infant breast feeding and combined diet therapy can promote maternal lactation in premature infants, raise the rate of breastfeeding, reduce the incidence of intestinal intolerance in preterm infants, and promote the growth and development of premature infants. Infant health is important.