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HPALanolin防治乳头皲裂的效果评估及可行性研究报告

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HPALanolin防治乳头皲裂的效果评估及可行性研究 浙江大学医学部 护理学 硕士研究生 章瑶 导 师 徐鑫芬 中文摘要 目的 观察比较HPA Lanolin对孕产妇乳头皲裂或疼痛的临床预防效果。探索HPA Lanolin在临床预防乳头疼痛/皲裂的应用可行性。 方法 采用随机对照设计。依照纳入及排除标准选取2011年9月至2011年11月在 浙江大学附属妇产科医院分娩的符合条件的孕产妇共210例。随机分为产前干预 组、产后干预组、空白对照组。产前干预组在分娩前实施干预措施,产后干预组 于产后立即实施干预措施。每一组均给予正确母乳喂养姿势指导,以及相关评估, 帮助孕产妇掌握母乳喂养的相关知识。住院期间评估其喂哺姿势及乳头疼痛情况。 结果 产前干预组与产后干预组的乳头皲裂发生率均低于空白对照组,并且产前干 预组降低乳头皲裂的发生率(p<0.05)。在一定程度上,HPALanolin能够缓解产妇 II 浙江大学硕士学位报告 中文摘要 乳头疼痛(p < 0.05)。初乳空白对照组与产后干预组产后发生乳头皲裂的相对危险度 OR值为2.909 (95%CI:1.056,8.011)和2.207 (95%CI:0.778,6.259),即初乳空白对照 组与产后干预组,产后发生乳头皲裂的潜在危险性是产前干预组的2~3倍。 结论 HPALanolin对产后乳头皲裂的发生具有预防效果,产前应用效果更为显著。 HPALanolin在一定程度上能够缓解乳头疼痛,提高早期纯母乳喂养成功率。 关键词:母乳喂养;乳头皲裂;乳头疼痛;初乳;HPALanolin;预防 ill 浙江大学硕士学位报告 英文摘要 An Evaluative Research of Preventive Effect of HPA Lanolin on Nipple Cracks in Chinese Breastfeeding Women Zhejiang University School of Medicine Postgraduate Yao Zhang Supervisor Xinfen Xu Abstract Objective The aim of this study was to evaluate the effects and effectiveness of HPA lanolin on prevention of sore and cracked nipples during breastfeeding in comparison with the application of expressed breast milk (EBM) in Chinese Breastfeeding Women. Methods 210 pregnant women were enrolled and randomized into a control group (70 cases), a prenatal intervention group (70 cases) and a postpartum intervention group (70 cases). The health education of breastfeeding positioning was implemented in all groups. In addition, both intervention groups were treated with lanolin in different time points, and control group was treated with EBM. Then, nipple trauma and healing rates were rated by a nipple trauma score. Nipple pain intensity was assessed with visual analog scale (VAS). Each one was also assessed their posture of breastfeeding by maternal-infant nurses in hospital and followed for 1?:2 telephone calls within 14 days. Results Women who received prenatal intervention of lanolin were less likely to IV 浙江大学硕士学位报告 英文摘要 experience nipple cracks (8.57%) compared to women using EBM (21.43%: p < 0.05). Women who used the HPA Lanolin in antenatal period on a daily basis were less likely to have a cracked nipple than women who used EBM (OR 2.909, 95%CI: 1.056, 8.011; p < 0.05) and women who used HPA Lanolin after nipple cracked (OR 2.207, 95%CI: 0.778, 6.259; p =0.1). Nipple pain in the prenatal intervention group was lower than the expressed breast milk group (OR 3.752, 95% CI: 1.852, 7.592; p<0.05) and postpartum intervention group (OR 2.361,95% CI: 1.174, 4.756; p < 0.05), Conclusions The research indicated that HPA lanolin has the preventive effect on nipple cracks, and the effect of the application of HPA Lanolin seems more significant than other two groups. To some extent, HPA lanolin can relieve the nipple pain during breastfeeding process and be beneficial to promote the success of exclusive breastfeeding in the early period of breastfeeding. Keywords: Breastfeeding; Nipple Cracks; HPA Lanolin; Prevention v 浙江大学硕士学位报告 符号说明 符号说明 M 目次 * * I 巾文摘要 n 英文摘要 iv 符号说明 VI 目 次 正 文 1 f t l 1.1研究背景及意义 1 1.2研究目的 3 1.3关键词 3 2研究对象 5 2.1研究对象来源 5 2.2纳入标准 5 2.3排除标准 5 2.4 样本量估计 6 3研究方法 7 3.1研究工具与材料 7 3.2检测及评价指标 11 3.3研究步骤 13 3.4数据的统计学处理 14 3.5技术路线 15 4结果与分析 16 4.1比较三组产妇一般资料的分布情况 16 4.2比较各组产后乳头皲裂的发生情况 17 4.3比较各组发生皲裂的程度 19 4.4比较各组乳头疼痛程度 20 4.5比较产后2周产妇的乳头状况及母乳喂养情况 22 5 M ^ 23 5.1 HPALanolin预防乳头皲裂的可能的作用机理 23 5.2 HPA Lanolin影响产后乳头皲裂的发生率 24 5.3 HPA Lanolin对乳头皲裂程度的影响 24 5.4 HPALanolin缓解乳头疼痛的效果 25 5.5发生产后乳头皲裂的潜在危险性 26 6 续 it 27 7