乳头保护罩用于解决产妇乳头皲裂母乳喂养的方法探讨

Application of nipple shield in women with cracked nipple to solve the breast-feeding

目的 探讨乳头保护罩用于解决产妇乳头皲裂母乳喂养的应用及疗效。方法 选取2012年9月—2014年9月广东医学院附属中山医院产科乳头皲裂坚持继续母乳喂养的产妇30例作为观察组,采用乳头保护罩辅助治疗,对照组应用传统方法：乳头表面涂羊脂膏,人工挤奶,观察其愈合进度、疼痛程度、恢复喂奶时间、并发症、满意度。结果 产妇在使用乳头护罩后均能继续母乳喂养,2 d内好转,3~7 d痊愈,平均5.1 d,与对照组比较,差异有统计学意义（P〈0.05）。其中,观察组中重度疼痛5例,对照组15例,差异有统计学意义（χ^2=7.55,P〈0.05）,观察组3例疼痛缓解时间〉24 h,对照组27例,2组比较差异有统计学意义（χ^2=38.53,P〈0.05）;观察组24 h内恢复哺乳20例,中止哺乳1例,对照组24 h内恢复哺乳仅为2例,中止哺乳9例,2组比较差异有统计学意义（χ^2=25.98,P〈0.05）;并发症（包括乳头水肿、乳腺炎、乳腺脓肿）方面,观察组发生1例,并发症发生率3.33%,对照组发生6例,并发症发生率20.00%,观察组并发症明显少于对照组,2组比较差异有统计学意义（χ^2=4.04,P〈0.05）;在患者舒适度、满意度方面,观察组亦优于对照组,但其差异无统计学意义（P〉0.05）。结论 采用乳头保护罩用于解决产妇乳头皲裂继续母乳喂养效果确切,且安全简便、容易操作。

Objective To investigate the application and effect of nipple shield as the method to solve the breast-feeding of puerpera with cracked nipple. Methods Thirty cases of puerpera with cracked nipple continuing breast-feeding in our hospital from September,2012 to September,2014 were selected as the observation group,and accepted nipple shield adjuvant therapy; while the control group accepted traditional methods： papillary surface coated lanolin cream,artificial milking. The progress of the healing,pain,time to recovery feeding,incidence of complications,and patient satisfaction were observed. Results The women with use of nipple shields in the observation group could continue the breast-feeding,the status were improved in two days,and healed in 3-7 d（ average 5. 1 d）,when compared with the control group,the difference was statistically significant（ P〈0. 05）. Five cases in the observation group and 15 cases in the control group were with moderate to severe pain,there was significant difference（ chi square value was of 7. 55,P〈0. 05）; One case in the observation group and 27 cases in the control group were with long pain time over 24 h,there was statistically significant differences between the two groups（ chi square value was of 38. 53,P〈0. 05）; in the observation group,20 cases recovered to breast-feeding in 24 h,1 cases discontinued breast-feeding,while in the control group,2 cases recovered to breastfeeding in 24 h,9 cases discontinued breast-feeding,there was statistically significant differences between the two groups（ chi square value was of 25. 98,P〈0. 05）; The incidence of complications（ including papillary edema,mastitis,breast abscess） in the observation group was 3. 33%（ 1 /30）,in the control group was 20%（ 6 /30）,so the incidence of complications in the observation group was significantly less than that in the control group,there was statistically significant differences between the two groups（ chi square value was of 4. 04,P〈0. 05）; Patient comfort and satisfaction in the observation group was also better than those in the control group,but the difference was not statistically significant（ P〉0. 05）.Conclusion The effect of nipple shield for solving breastfeeding in the women with cracked nipple is exact. The method is simple,easy and safe.