哺乳期乳腺炎常见高危因素提前干预后预防效果分析

Analysis of prevention effect of early intervention on common high risk factors of lactation mastitis

目的 探讨通过对哺乳期乳腺炎常见的几种高危因素进行提前干预,观察减少乳腺炎发生的效果。方法 回顾性分析2020-01-01-12-31临沂市妇幼保健院乳腺科门诊接诊的孕期行乳腺疾病筛查,具有乳腺炎高危因素的孕妇555名作为研究对象。根据孕妇意愿分为干预组(292名)和对照组(263名)。干预组针对不同高危因素在孕期和产后进行提前干预,对照组按照患者意愿对高危因素不进行提前干预。比较2组孕妇哺乳期乳腺炎高危因素的构成及发生乳腺炎的情况。结果 干预组均顺利接受干预和随访,对照组未接受干预,完成随访。干预组与对照组乳头畸形分别占6.5%和4.6%,χ^(2)=0.992,P=0.319;乳头皲裂分别占3.4%和3.0%,χ^(2)=0.065,P=0.799;手术外伤史分别占8.6%和6.5%,χ^(2)=0.871,P=0.351;既往乳腺炎史分别占2.1%和1.5%,χ^(2)=0.223,P=0.637;乳汁分泌过多分别占38.0%和40.7%,χ^(2)=0.414,P=0.520;含乳方式不妥分别占19.2%和20.5%,χ^(2)=0.160,P=0.689;母婴分离分别占20.2%和21.3%,χ^(2)=0.100,P=0.752;俯卧位睡眠分别占2.1%和1.9%,χ^(2)=0.017,P=0.897;2组上述高危因素比较,差异均无统计学意义。干预组发生乳腺炎102例(34.9%),对照组为120例(45.6%),差异有统计学意义,χ^(2)=6.596,P=0.010。结论 在孕期或产后对哺乳期乳腺炎高危因素提前进行干预,可有效减少乳腺炎的发生,做到精准预防。

Objective To investigate the effect of reducing the occurrence of mastitis by intervening in advance the common high risk factors of lactation mastitis.Methods A retrospective analysis was performed on 555 pregnant women with high risk factors for mastitis who underwent breast disease screening during pregnancy from January 1 to December 31,2020 in the breast clinic of Linyi Maternal and Child Health Hospital.These women were divided into intervention group(292 cases)and control group(263 cases)based on their willingness.Intervention group received early intervention for different high risk factors during pregnancy and postpartum,while the control group did not receive early intervention for high risk factors according to the patients'wishes.The composition of high-risk factors for lactating mastitis and the incidence of mastitis between two groups of pregnant women were compared.Results The intervention group received intervention and follow-up successfully,while the control group did not receive intervention and completed follow-up.The incidence of nipple deformity was 6.5%in the intervention group and 4.6%in the control group,χ^(2)=0.992,P=0.319.The incidence of nipple cracking accounted for 3.4%and 3.0%,respectively,χ^(2)=0.065,P=0.799.A history of surgical trauma accounted for 8.6%and 6.5%,respectively,χ^(2)=0.871,P=0.351.A history of previous mastitis accounted for 2.1%and 1.5%,respectively,χ^(2)=0.223,P=0.637.Excessive milk secretion accounted for 38.0%and 40.7%,respectively,χ^(2)=0.414,P=0.520.Inappropriate breastfeeding methods accounted for 19.2%and 20.5%,respectively,χ^(2)=0.160,P=0.689.Maternal and neonatal separation accounted for 20.2%and 21.3%,respectively,χ^(2)=0.100,P=0.752.Prone sleep position accounted for 2.1%and 1.9%,respectively,χ^(2)=0.017,P=0.897.There was no statistically significant difference between the two groups of high-risk factors mentioned above.There were 102 cases(34.9%)of mastitis in the intervention group and 120 cases(45.6%)in the control group,with a statistically significant difference,χ^(2)=6.596,P=0.010.Conclusion Individualized intervention in advance of high risk factors of acute mastitis during pregnancy or postpartum can effectively reduce the occurrence of mastitis and achieve precise prevention.