Title: Effects of Implementing Early Nursing Interventions on Jaundice in Premature Infants ABSTRACT Objectives: To explore the effects of implementing enema combined with massage on jaundice in premature infants. Differences were compared among enema combined with massage, abdominal massage, and routine enema as well as double-side phototherapy and so was the control group. Clinical advantages and disadvantages of these early interventions for preventing neonatal jaundice and reducing complications were analyzed to find out a simple, effective and woundless nursing intervention which also has clinical values and social effects. Methods: 125 premature infants were randomly assigned into group A, B, C, D and E. All infants in the five groups received identical nutrition and drug therapy. The infants in group A, B and D were given early abdominal massage, routine enema and enema combined with massage respectively. Group C was the double-side phototherapy group and group E was the control group. When transcutaneous bilirubin (TCB) indexes counted more than 18.0, group A, B, D and E were given routine single-side phototherapy for 24 hours. Double-side phototherapy was applied in group C when TCB indexes were over 18.0. Neither enema nor abdominal massage was given to group C and E. Neonatal jaundice, defecation and feeding were recorded. ANOVA, test were used to analyze the data. Results: The time for jaundice lasting and phototherapy were significantly shorter in group D than other four groups (P<0.05). Transcutaneous bilirubin (TCB) indexes of those hospitalized for at least two weeks were lower in group D than those in group A, B and E (P<0.05). The incidence of Hyperbilirubinemia and the rate of jaundice extinction in the first two weeks showed significant differences in the 5 groups (P<0.01).The incidence of Hyperbilirubinemia in group D was remarkably lower than those in group E, and the rate of jaundice extinction in the first two weeks of infants in group D was lower than those in group A and E (P<0.005). The time for meconium exhaustion in group D was shorter than group B, C and E (P<0.01).In group D, total defecation times in the first five days, first seven days and the first two weeks were obviously more than other four groups (P<0.05). The incidences of constipation and feeding intolerance showed significant differences in the five groups (P<0.01).The incidence of feeding intolerance of those in group D was lower than those in group B and E (P<0.005), and the incidence of constipation of those in group D was lower than other four groups (P<0.001). Conclusion: Implementing enema combined massage early on premature infants after birth can encourage more meconiums exhaustion and promote excretion of bilirubin. It can also help jaundice extinction, shorten the time of phototherapy as well as lower the incidence of Hyperbilirubinemia. Still, it can promote the intestinal movement and enhance feeding intolerance.
