疏松式乳房按摩在剖宫产术后预防乳房肿胀及促进泌乳的临床研究

谭茵 刘伟武 李春艺 林树坤 谢萍 黎菲 朱睿颖

【摘要】 目的 探讨疏松式乳房按摩对剖宫产术后乳房肿胀及促进泌乳的治疗效果。

方法 选取2020年1月1日～12月31日剖宫产术分娩的足月单胎初产妇400例，按照随机数表分为对照组和观察组各200例。对照组产妇给予常规护理，观察组产妇在常规护理基础上结合疏松式乳房按摩，对比两组产妇的乳房肿胀情况、泌乳情况和产后第三天血清泌乳素（PRL）、雌二醇（E2）水平。

结果 观察组分娩后乳房肿胀疼痛情况较对照组明显减轻 （P<0.01）。观察组分娩后泌乳情况优于对照组 （P<0.01）。产后3 d ，观察组血清PRL水平与对照组比较显著提高（P<0.01），而E2水平较对照组明显降低（P<0.01）。

结论 通过对产妇进行疏松式乳房按摩护理，能够促进母乳分泌，减轻和缓解乳房肿胀，提高血清PRL水平，降低血清E2水平，改善和促进产后泌乳，取得了较好的临床效果，值得推广应用。

【关键词】 疏松式乳房按摩;剖宫产术;乳房肿胀;泌乳

中图分类号：R473.71   文献标志码：A   DOI：10.3969/j.issn.1003-1383.2021.05.006

【Abstract】 Objective To explore the therapeutic effect of loose breast massage on  prevention of breast swelling and promotion of lactation after cesarean section.

Methods A total of 400 full-term single primipara who gave birth by cesarean section in our hospital from January 1 to December 31， 2020 were selected and divided into control group and observation group according to random number table， with 200 cases in each group. The control group were given routine nursing， and the observation group were given loose breast massage on the basis of routine nursing. And then， breast swelling， lactation as well as serum prolactin （PRL） and estradiol （E2）   levels on the third day after delivery were compared between the two groups.

Results Breast swelling and pain in the observation group were significantly alleviated than those in the control group after delivery （P < 0.01）. The lactation of the observation group was better than that in the control group （P < 0.01）. 3 days after delivery， the serum PRL level in the observation group was significantly higher than that in the control group （P < 0.01）， while the E2 level was significantly lower than that in the control group （P < 0.01）.

Conclusion Loose breast massage nursing for pregnant women can promote breast milk secretion， alleviate breast swelling and pain， increase serum PRL levels， reduce serum E2 levels， and improve lactation， which has achieved good clinical effects， and thus is worth popularizing and applying.

【Key words】 loose breast massage; cesarean section; breast swelling; lactation

研究[1]表明，嬰儿在出生6个月以内的最佳喂养方式为母乳喂养，母乳喂养能够促进产妇子宫恢复，提供新生儿发育所需营养物质，并且能够提高新生儿免疫力[2]。既往对剖宫产产妇促进泌乳干预多以口头宣教及饮食指导为主，缺乏能够直接改善患者乳房肿胀及促进产后泌乳的具体措施。由于产妇的乳量不足、泌乳延迟以及乳房胀痛等因素，加之手术后切口疼痛，活动及进食受到一定的限制，母乳喂养通常达不到预期的效果[3]。目前临床上常常会遇到，产妇由于乳腺导管不畅引起乳房肿胀使产妇的乳腺管堵塞从而影响乳汁分泌，严重时会导致乳腺炎的发生[4]。……