三明治式喂养在乳头扁平产妇母乳喂养中的应用效果评价

王甜 芦敏蔡丹

[摘要] 目的 探討三明治式喂养方式在乳头扁平产妇母乳喂养中的应用效果及价值。 方法 选取2019年1月至2020年3月在我院分娩的120例初产妇，随机分为对照组与干预组各60例，对照组产妇采取传统护理干预方式，干预组患者在传统护理的基础上开展三明治式喂养，依次对两组产妇的乳头皲裂、母乳喂养率及新生儿尿量、胎粪与体重等情况进行比较。 结果 两组患者的乳头皲裂发生率比较差异无统计学意义（χ2=1.205，P=0.272），干预组患者产后1周、产后1个月与产后3个月的母乳喂养率为51.67%、70.00%及88.33%，明显高于对照组，差异有统计学意义（χ2=7.869、17.638、17.788，P=0.005、0.000、0.000）。同时，两组患者的胎粪排出延迟发生率与Apgar 1 min评分比较差异无统计学意义（χ2/t=0.835、1.074，P=0.361、0.285），干预组患者的尿量不足发生率为1.76%，出生后1个月体重为（4.90±0.80）kg，出生后3个月体重为（6.10±1.10）kg，均显著高于对照组，差异有统计学意义（χ2/t=4.324、4.648、4.905，P=0.038、0.000、0.000）。 结论 在乳头扁平产妇中采取三明治式喂养方式能够显著提高母乳喂养率，也有助于保障新生儿的生长发育，具有确切应用价值。

[关键词] 产妇;乳头扁平;母乳喂养;三明治式喂养

[Abstract] Objective To investigate the application efficacy and value of sandwich feeding in breast-feeding of puerpera with flat nipple. Methods A total of 120 primiparas who delivered in our hospital from January 2019 to March 2020 were randomly divided into the control group（n=60） and the intervention group（n=60）. The control group was given conventional nursing intervention， while the intervention group was given sandwich feeding on the basis of conventional nursing. The nipple chapped， breastfeeding rate， neonatal urine volume， meconium and body weight of the two groups were compared successively. Results There was no statistically significant difference in the incidence of chapped nipples between the two groups（χ2=1.205， P=0.272）. The breast-feeding rates of the intervention group were 51.67%， 70.00% and 88.33% within 1 week， 1 month and 3 months after delivery， respectively， which were significantly higher than those of the control group， with statistically significant differences（χ2=7.869， 17.638， 17.788， P=0.005， 0.000， 0.000）. Moreover， there was no statistically significant difference between the two groups in the incidence of delayed meconium excretion between the two groups compared with Apgar 1 min score（χ2/t=0.835， 1.074， P=0.361， 0.285）. The incidence of insufficient urine volume in the intervention group was 1.67%， and the body weight within 1 month after birth was（4.90±0.80） kg and（6.10±1.10） kg within 3 months after birth， which were significantly higher than those in the control group（χ2/t=4.324， 4.648， 4.905， P=0.038， 0.000， 0.000）. Conclusion Sandwich feeding can significantly improve the breast-feeding rate of puerpera with flat nipples and help to ensure the growth and development of neonates， which has definite value of application.

[Key words] Puerpera; With flat nipples; Breastfeeding; Sandwich feeding method

母乳一直被认为是新生儿的理想食物[1]，母乳喂养方式能够为产妇及其新生儿带来较多健康益处[2]，当前国内外医疗机构均推荐母乳喂养方式，但母乳喂养率仍处于较低水平，还需进一步得到提高[3-4]。扁平乳头是常见的乳房畸形种类，也是影响母乳喂养的重要原因之一[5]，受到乳头扁平或凹陷的影响使得新生儿无法正常衔乳，转而选择人工喂养方式，而乳头扁平还会对乳汁流出形成影响，也容易造成乳头表面损伤情况，但该种情况通过局部刺激仍可促使乳头凸出，在有效干预后可正常哺乳。……