2013 , Vol. 07 >Issue 01: 39 - 42
DOI: https://doi.org/10.3877/cma. j. issn.1674-0807.2013.01.009
行为方式与哺乳期急性乳腺炎发病的相关性分析
Copy editor: 罗承丽
收稿日期: 2012-10-16
网络出版日期: 2024-12-07
版权
Correlation analysis between the patients' behaviors and acute lactational mastitis
Received date: 2012-10-16
Online published: 2024-12-07
Copyright
目的
调查行为方式与哺乳期急性乳腺炎发病之间的关系。
方法
收集2011 年1 月至2012 年3 月在北京市海淀区妇幼保健院就诊的哺乳期急性乳腺炎患者和有哺乳经历的非哺乳期健康妇女各237 例,进行问卷调查。 采用单因素分析及非条件Logistic 回归进行危险因素分析,以探讨行为方式与哺乳期急性乳腺炎发病之间的关系。
结果
单因素分析显示哺乳时间(χ2=116.88,P=0.00)、睡眠姿势(χ2=49.47,P=0.00)、婴儿吸乳方式(χ2=74.64,P=0.00)、清洗乳头(χ2=61.80,P=0.00)及乳房外伤(χ2=16.77,P=0.00)与哺乳期急性乳腺炎的发生有关,负性情绪(χ2=1.03,P=0.31)、每次哺乳时间(χ2=7.30,P=0.12)与哺乳期急性乳腺炎无关。 多因素分析显示: 哺乳期急性乳腺炎发病的危险因素为平卧和乳房外伤(OR=2.27,95%CI: 1.25 ～4.14;OR=3.24,95%CI: 1.31 ～7.97);保护因素为吸住乳头乳晕的吸乳方式(OR=0.09,95%CI: 0.05 ～0.19),哺乳时间6 个月以上(OR=0.05,95%CI: 0.02 ～0.11),每次哺乳前清洗乳头(OR=0.17, 95%CI: 0.09 ～0.34)。
结论
产后6 个月内都是哺乳期急性乳腺炎的高发期;正常的侧卧睡眠不增加哺乳期急性乳腺炎的风险;在哺乳时让婴儿吸住乳头乳晕、经常清洗乳头等行为对预防哺乳期急性乳腺炎的发生有积极作用。 哺乳期急性乳腺炎与负性情绪、每次哺乳持续时间无关。
何湘萍 , 马祥君 , 赵银珠 , 高海凤 , 何燕 . 行为方式与哺乳期急性乳腺炎发病的相关性分析[J]. 中华乳腺病杂志(电子版), 2013 , 07(01) : 39 -42 . DOI: 10.3877/cma. j. issn.1674-0807.2013.01.009
Objective
To investigate the relationship between the patients' behaviors and the occurrence of acute lactational mastitis.
Methods
Totally 237 patients diagnosed as having acute lactational mastitis in our hospital from January 2011 to March 2012 and 237 healthy female volunteers who were not in lactation but with breastfeeding experience were enrolled in the study. The data was collected through a questionnaire and then univariate analysis and logistic regression analysis were performed to investigate the relationship between the patients'behaviors and the occurrence of the acute lactational mastitis.
Results
The univariate analysis showed that the duration of breastfeeding (χ2=116.88,P=0.00), sleeping posture (χ2=49.47,P=0.00), way of milk sucking (χ2=74.64,P=0.00), cleaning of the nipple (χ2=61.80,P=0.00)and trauma of the breast (χ2=16.77,P=0.00)were the relative factors. The negative emotions (χ2=1.03,P=0.31)and the time length of breastfeeding (χ2 =7.30,P=0.12)were not related with the acute lactational mastitis. The multivariate analysis showed that the supine position in sleep (OR=2.27,95%CI: 1.25-4.14)and breast trauma (OR=3.24, 95%CI: 1.31-7.97) were risk factors; the way of sucking the nipple and areola (OR=0.09,95%CI: 0.05-0.19), breastfeeding for more than 6 months (OR=0.05, 95%CI: 0.02-0.11), cleaning nipples before breastfeeding(OR=0.17, 95%CI: 0.09-0.34) were the protective factors.
Key words： behavior; lactation; acute mastitis; risk factors
表1 调查资料部分变量赋值表 |
| 变量 | 赋值 | ||
|---|---|---|---|
| 哺乳时间 | ＜1个月=1 | 1～6个月=2 | ＞6个月=3 |
| 婴儿吸乳方式 | 只吸乳头=1 | 吸住乳头乳晕=2 | |
| 睡眠姿势 | 侧卧=1 | 平卧=2 | 俯卧=3 |
| 清洗乳头 | 不经常清洗=1 | 每天清洗2～3次=2 | 每次哺乳前清洗=3 |
| 是否有外伤 | 否=0 | 有=1 | |
| 有否不良情绪 | 否=0 | 有=1 | |
| 哺乳持续时间 | ≤20min=1 21～30min=2 | 31～60min=3 ＞60min=4 | 无规律=5 |
表2 病例组与对照组间哺乳期急性乳腺炎影响因素比较 |
| 因素 | 病例组[例(%)] | 对照组[例(%)] | χ 2值 | P值 |
|---|---|---|---|---|
| 哺乳时间 | 116.88 | 0.00 | ||
| ＜1个月 | 56(23.63) | 25(10.55) | ||
| 1～6个月 | 140(59.07) | 55(23.21) | ||
| ＞6个月 | 41(17.30) | 157(66.24) | ||
| 睡眠姿势 | 49.47 | 0.00 | ||
| 侧卧 | 138(58.23) | 183(77.22) | ||
| 平卧 | 99(41.77) | 38(16.03) | ||
| 俯卧 | 0(0.00) | 16(6.75) | ||
| 负性情绪 | 1.03 | 0.31 | ||
| 有 | 123(51.90) | 134(56.54) | ||
| 无 | 114(48.10) | 103(43.46) | ||
| 婴儿吸乳方式 | 74.64 | 0.00 | ||
| 只吸乳头 | 30(12.66) | 117(49.37) | ||
| 吸住乳头乳晕 | 207(87.34) | 120(50.63) | ||
| 每次哺乳时间 | 7.30 | 0.12 | ||
| ≤20min | 91(38.40) | 80(33.76) | ||
| 21～30min | 75(31.65) | 76(32.07) | ||
| 31～60min | 40(16.88) | 30(12.66) | ||
| 60min以上 | 7(2.95) | 9(3.80) | ||
| 无规律 | 24(10.12) | 42(17.72) | ||
| 清洗乳头 | 61.80 | 0.00 | ||
| 不经常清洗 | 68(28.69) | 30(12.66) | ||
| 每天清洗2～3次 | 102(43.04) | 55(23.21) | ||
| 哺乳前均清洗 | 67(28.27) | 152(64.14) | ||
| 乳房外伤 | 16.77 | 0.00 | ||
| 有 | 43(18.14) | 14(5.91) | ||
| 无 | 194(81.86) | 223(94.09) |
表3 哺乳期急性乳腺炎影响因素的非条件logistic 回归分析结果 |
| 变量 | B值 | Wald值 | P值 | OR值 | 95%CI | |
|---|---|---|---|---|---|---|
| 低限 | 高限 | |||||
| 哺乳时间 | ||||||
| ＜1个月 | 1.00 | |||||
| 1～6个月 | -0.45 | 1.39 | 0.24 | 0.64 | 0.30 | 1.35 |
| ＞6个月 | -3.05 | 51.39 | 0.00 | 0.05 | 0.02 | 0.11 |
| 睡眠姿势 | ||||||
| 侧卧 | 1.00 | |||||
| 平卧 | 0.82 | 7.12 | 0.01 | 2.27 | 1.25 | 4.14 |
| 俯卧 | -22.88 | 0.00 | 0.99 | 0.00 | 0.00 | |
| 吸住乳头乳晕的吸乳方式 | -2.37 | 50.23 | 0.00 | 0.09 | 0.05 | 0.19 |
| 清洗乳头 | ||||||
| 不经常清洗乳头 | 1.00 | |||||
| 每天清洗2～3次乳头 | -0.12 | 0.10 | 0.75 | 0.89 | 0.44 | 1.80 |
| 哺乳前均清洗乳头 | -1.77 | 25.06 | 0.00 | 0.17 | 0.09 | 0.34 |
| 乳房外伤 | 1.18 | 6.53 | 0.01 | 3.24 | 1.31 | 7.97 |
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