Cottrell B H, Anderson G C
J Pediatr Gastroenterol Nutr. 1984 Nov;3(5):734-9.
Physiologic jaundice (5-6 mg/100 ml plasma bilirubin) is common and considered normal in newborn infants during the first week postbirth, but is considered abnormal in older infants. Early meconium passage correlates with lower plasma bilirubin concentrations. Rectal stimulation during rectal temperature measurement may aid passage of meconium containing potentially toxic, absorbable bilirubin. In this study, 100 clinically normal infants were assigned randomly to groups for rectal or axillary temperature measurement. The time of first meconium passage, time of first all-yellow stool, and total plasma bilirubin were compared between groups. Bilirubin was measured during metabolic screening at 48-80 h postbirth (mean 69 h in both groups). By this time 30 infants in the rectal group, but only 17 in the axillary group, had passed yellow stools (p = 0.011). The rectal group had lower mean (+/- 1 SD) bilirubin (5.5 mg/100 ml +/- 2.7 vs. 6.5 +/- 3.0, p = 0.042), and a trend toward earlier first meconium (5.9 h +/- 5.0 vs. 7.3 +/- 5.9, p = 0.096). For clinically normal infants in the first 48-80 h postbirth, these data suggest that rectal stimulation accompanying rectal temperature measurement enhances intestinal bilirubin excretion because of more rapid meconium passage.
生理性黄疸（血浆胆红素5 - 6mg/100ml）在出生后第一周的新生儿中很常见且被认为是正常的，但在较大婴儿中则被视为异常。较早排出胎粪与较低的血浆胆红素浓度相关。在测量直肠温度时进行直肠刺激可能有助于含有潜在毒性、可吸收胆红素的胎粪排出。在本研究中，100名临床正常的婴儿被随机分组进行直肠或腋窝温度测量。比较了两组之间首次排出胎粪的时间、首次排出全黄色粪便的时间以及血浆总胆红素。在出生后48 - 80小时（两组平均均为69小时）进行代谢筛查时测量胆红素。此时，直肠组有30名婴儿排出了黄色粪便，而腋窝组只有17名（p = 0.011）。直肠组的平均胆红素水平（±1标准差）较低（5.5mg/100ml±2.7 vs. 6.5±3.0，p = 0.042），并且首次排出胎粪有提前的趋势（5.9小时±5.0 vs. 7.3±5.9，p = 0.096）。对于出生后最初48 - 80小时内临床正常的婴儿，这些数据表明，测量直肠温度时伴随的直肠刺激可促进肠道胆红素排泄，因为胎粪排出更快。
