行为方式与哺乳期急性乳腺炎发病的相关性分析

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（χ^2=116．88,P=0．00）、睡眠姿势（χ^2=49．47,P=0．00）、婴儿吸乳方式（χ^2=74．64,P=0．00）、清洗乳头（χ^2=61．80,P=0．00）及乳房外伤（χ^2=16．77,P=0．00）与哺乳期急性乳腺炎的发生有关,负性情绪（χ^2=1．03,P=0．31）、每次哺乳时间（χ^2=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。

Correlation analysis between the patients' behaviors and acute lactational mastitis

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 （χ^2= 116. 88, P= 0. 00）, sleeping posture （χ^2= 49.47 ,P=0. 00）, way of milk sucking （ χ^2=74. 64,P=0. 00）, cleaning of the nipple （χ^2 =61.80 ,P=0. 00） and trauma of the breast （χ^2= 16. 77, P = 0. 00 ） were the relative factors. The negative emotions （ χ^2= 1.03, P = 0. 31 ） and the time length of breasffeeding （ χ^2 = 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.Conclusions The acute lactational mastitis often occurrs in the first 6 months postpartum. Normal side-lying sleep does not increase the risk of the acute lactational mastitis. It can effectively prevent the acute lactational mastiffs by sucking the nipple and areola altogether, and regularly cleaning the nipple. The negative emotions and the time length of breastfeeding are not relevant factors.