李雯馨+罗琳雪+黄凤形+李成香+陈丽芬+凌燕兰

【摘要】目的促進母婴分离产妇泌乳的干预模式。方法选择2013年3月～2014年3月住院分娩后母婴分离的产妇240例为研究对象，随机分为A组、B组和C组，A组按传统的母婴分离常规护理，B组给予超早期乳房护理干预，C组用产后康复治疗仪干预；干预后比较三组的泌乳始动时间，产后72 h的血清泌乳素水平、泌乳量及乳房肿胀的发生率。结果三组间泌乳始动时间比较有统计学意义（F=49.02，P<0.001），两两比较，B组、C组的泌乳始动时间较A组明显提前（P均<0.01），B组与C组之间差异无统计学意义（P>0.05）；三组间血清泌乳素水平比较差异有统计学意义（F=181.73，P<0.001），两两比较，B组、C组的血清泌乳素水平高于A组（P均<0.01），B组与C组之间差异无统计学意义（P>0.05）；三组间泌乳量比较有统计学意义（F=98.46，P<0.001），两两比较，B组、C组的泌乳量多于A组（P均<0.01），B组与C组之间差异无统计学意义（P>0.05）；三组间乳房肿胀发生率比较有统计学意义（χ2=8.233， v=2， P=0.016），两两比较，B组、C组的乳房肿胀发生率远低于A组（P均<0.05），而B组与C组差异不大（P>0.05）。结论超早期乳房护理干预与产后康复治疗仪干预均可使泌乳始动提前，血清泌乳素水平提高，泌乳量增加，乳房胀痛减轻，提高母乳喂养成功率，两种方法均操作简单、无创，临床上可根据产妇的需要选择应用。

【关键词】母婴分离；泌乳；干预模式

中图分类号：R473.71文献标识码：ADOI：10.3969/j.issn.10031383.2016.05.014

【Abstract】ObjectiveTo study the intervention mode that promoting lactation in puerpera with maternal separation.Methods240 puerpera with maternal separation after delivery from March，2013 to March，2014 were randomly divided into group A，group B，and group C with 80 cases in each.The group A were given traditional maternal separation routine nursing care，the group B were given ultra early breast care，and the group C were given postpartum rehabilitation instrument.And then，initial time of lactation，serum level of prolactin 72 h after delivery，lactation amount 72 h after delivery and the incidence of breast swelling 72 h after delivery in the 3 groups were compared after intervention.ResultsDifference of the initial time of lactation of the 3 groups was statistically significant（F=49.02，P<0.001）.And the initial time of lactation in the group B and group C were evidently earlier than that of the group A（all P<0.01），difference of the initial time of lactation in the group B and group C was not statistically significant（P>0.05）.Difference of the serum levels of prolactin of the 3 groups was statistically significant（F=181.73，P<0.001）.And the serum levels of prolactin in the group B and the group C were evidently higher than that of the group A（all P<0.01），difference of the serum levels of prolactin in the group B and group C was not statistically significant（P>0.05）.Difference of the lactation amount of the 3 groups was statistically significant（F=98.46，P<0.001）.Lactation amount of the group B and group C was larger than that of the group A（all P<0.01），difference of the lactation amount in the group B and group C was not statistically significant（P>0.05）.Difference of the incidence of breast swelling of the 3 groups was statistically significant（χ2=8.233，v=2，P=0.016），and incidence of breast swelling of the group B and group C was significantly lower than that of the group A（all P<0.05），but the difference between group B and group C had not statistical significance （P>0.05）.ConclusionBoth ultra early breast care and postpartum rehabilitation instrument can make initial time of lactation in advance，increase serum prolactin level and lactation amount，alleviate breast distending pain and improve breastfeeding success rate.Both methods are simple and noninvasive，they should be selected according to the needs of women who give birth in clinical practice.

【Key words】maternal separation；lactation；intervention mode

母乳含有婴幼儿生长发育必需的各种营养成分，是婴儿生长发育最理想的天然食品，具有经济、方便、容易消化吸收等人工喂养无法比拟的优点[1]。但有部分婴儿出生后，由于各种原因需转至新生儿监护室（NICU）接受治疗而导致母婴分离，资料报道[2]，母婴分离婴儿占出生婴儿的10%左右。由于母婴分离，产后产妇的乳房无法得到及时、有效的吸吮，加之产妇担心婴儿健康、紧张、焦虑等因素，导致泌乳始动时间延迟、泌乳量不足[2]。……