术后口服营养补充和规范化饮食干预对剖宫产产妇早期恢复情况的效果研究

Effects of oral nutrition supplements and standard dietary intervention on postpartum recovery in parturients with cesarean section

目的:探讨口服营养补充(ONS)对剖宫产术后产妇胃肠功能恢复、泌乳及营养状况等的影响。方法:自2018年3月至2019年3月,筛选符合纳入标准的剖宫产产妇410例,随机分为实验组和对照组各205例,实验组术后6 h开始给予口服肠内营养液、标准化的过渡期和月子期膳食,对照组仍采用传统自制饮食方式;观察两组术后肛门排气时间、泌乳开始时间、泌乳量水平、术后血清营养指标(血清总蛋白、白蛋白、血红蛋白)、术后发热和胃肠道不适发生率。结果:实验组肛门排气时间和泌乳开始时间均早于对照组,两组比较差异有统计学意义(P<0.05);实验组24 h内和48 h后的泌乳量水平均高于对照组,两组比较差异有统计学意义(P<0.05);实验组术后3 d的血清总蛋白和白蛋白水平均高于对照组,两组比较差异有统计学意义(P<0.05);实验组术后发热和胃肠道不适症状的发生率低于对照组,两组比较差异有统计学意义(P<0.05)。结论:剖宫产术后早期ONS可促进胃肠道功能恢复,促进早泌乳和增加泌乳量;同时配合后续的标准化饮食干预,可改善剖宫产产妇营养状态,促进产后快速恢复,避免产褥期感染等并发症和术后不适症状的发生。

Objective:To investigate the effects of oral nutrition supplements on gastrointestinal function,lactation and nutritional status in women with cesarean section.Methods:A total of 410 women who underwent cesarean section between March 2018 and March 2019 in our hospital were enrolled in this study.They were randomly divided into two groups:the experimental and control groups(205 cases each group).The experimental group was given oral nutrition supplements,standard transitional diets and lactational diets at 6h post cesarean section.The control group was only given traditional diets.The anus exhausting time after cesarean section,the initial time of lactation,the lactation yield,and the uncomfortable symptoms were recorded.The serum levels of total protein(TP),albumin(ALB)and hemoglobin(HB)were determined.Results:The anus exhausting time and the initial time of lactation in the experimental group were shorter than in the control group(P<0.05).In the experimental group,the lactation yield during<24 h and>48 h after cesarean section were higher than in the control group(P<0.05).The levels of HB and ALB in the experimental group were higher than in the control group(P<0.05).The prevalence of uncomfortable symptoms was lower in the experimental group(P<0.05).Conclusion:Early oral nutrition supplements after cesarean section could contribute to gastrointestinal recovery and lactation,and in combination with standard diets,could improve the puerperants’nutritional status and reduce the occurrence of postpartum complications.