Chen Yongmei,Huang Yan,Xiong Qiongzhen,et al.Retrospective analysis of clinical characteristics of nocturnal enuresis in 252 children[J].Journal of Clinical Pediatric Surgery,2021,20(06):588-591.[doi:10.12260/lcxewkzz.2021.06.015]
252例儿童夜遗尿症的临床特征分析
- Title:
- Retrospective analysis of clinical characteristics of nocturnal enuresis in 252 children
- Keywords:
- Nocturnal Enuresis/DI; Nocturnal Enuresis/TH; Clinical Characteristics; Urination Diary; Child
- 分类号:
- R726.945.3
- 摘要:
- 目的 调查夜遗尿患者临床特征，帮助医务人员准确判断夜遗尿，避免误诊和漏诊。方法 回顾性分析四川大学华西医院2018年6月至2019年2月就诊的252例夜遗尿症患者的临床资料及排尿日记，分析夜遗尿症患者的临床特征。结果 252例夜遗尿患者中，单症状夜遗尿患者130例（51.59%），非单症状夜遗尿患者94例（37.30%），膀胱过度活动症28例（11.11%）。出现功能性膀胱容量减少121例（48.02%），夜间多尿51例（20.23%），夜尿多及功能性膀胱容量减少16例（6.35%），夜间尿量和膀胱容量正常64例（25.40%）。夜遗尿儿童临床表现特征排前三位的是难以唤醒、便秘和饮水。儿童夜遗尿遗传因素占14.29%。结论 夜遗尿就诊患者中以合并膀胱问题为主，患者最常见的临床特征为夜间睡眠过深、难以唤醒。关注夜遗尿患者的临床特征及排尿日记，正确识别、判断、决策，有助于为夜遗尿患者提供更优质的诊疗服务。
- Abstract:
- Objective To explore the general profiles and clinical characteristics of children with nocturnal enuresis (NE) so as to help clinicians make accurate judgments and decisions of NE and avoid its misdiagnosis and underdiagnosis.Methods Retrospective analysis of clinical data and urination diary was performed for 252 NE children from June 2018 to February 2019 and descriptive statistical analysis conducted for the relevant clinical characteristics.Results The clinical types were monosymptomatic enuresis (n=130,51.59%),non-monosymptomatic enuresis (n=94,37.30%) and overactive bladder (n=28,11.11%).Functional bladder volume reduction accounted for 48.02% (n=121);nocturnal polyuria 20.23% (n=51);nocturia polyuria and reduced functional bladder capacity 6.35% (n=16);normal nocturnal urine volume and bladder capacity 25.40% (n=64).The top three clinical manifestations of NE children were nocturnal sleep or difficult awaking,constipation and drinking.Genetic factors for NE accounted for 14.29%.Conclusion Bladder problems are more common in NE children.The most common clinical features of NE are nocturnal sleep and difficult awaking.Paying attention to clinical characteristics and diuretic diary of NE children and correctly identifying,judging and making decisions help provide better diagnostic and therapeutic services for NE children.
参考文献/References:
1 Austin PF,Bauer SB,Bower W,et al.The standardization of terminology of lower urinary tract function in children and adolescents:update report from the standardization committee of the International Children’s Continence Society[J].Neurourol Urodyn,2016,35(4):471-481.DOI:10.1002/nau.22751.
2 中华医学会小儿外科学分会小儿尿动力和盆底学组和泌尿外科学组.儿童遗尿症诊断和治疗中国专家共识[J].中华医学杂志,2019,99(21):1615-1620.DOI:10.3760/cma.j.issn.0376-2491.2019.21.005. Groups of Pediatric Uodynamics and Pelvic Floor Science and Urology,Pediatric Surgery Branch of Chinese Medical Association.Chinese Expert Consensus on the Diagnosis and Treatment of Childhood Enuresis[J].Chinese Journal of Medical Sciences,2019,99(21):1615-1620.DOI:10.3760/cma.j.issn.0376-2491.2019.21.005.
3 马源,文一博,汪玺正,等.河南地区婴幼儿把尿训练开始时间与排尿控制发育关系研究[J].现代泌尿外科杂志,2018,23(9):17-20,75.DOI:10.3969/j.issn.1009-8291.2018.09.004. Ma Y,Wen YB,Wang QZ,et al.Relationship between start time of voiding training and development of voiding control in infants and young children in Henan Province[J].Journal of Modern Urology,2018,23(9):17-20,75.DOI:10.3969/j.issn.1009-8291.2018.09.004.
4 Radmayr C,Bogaer G,Dogan HS,et al.EAU guidelines on paediatric urology[M].Arnhen:European Association of Urology,2018.DOI:10.1159/000049841.
5 文一博,汪玺正,王一鹤,等.郑州市6165名5~11岁儿童夜间遗尿症的现状调查[J].临床小儿外科杂志,2017,16(6):559-563.DOI:10.3969/j.issn.1671-6353.2017.06.008. Wang YB,Wang QZ,Wang YH,et al.Current status of nocturnal enuresis of 6165 children aged 5 to 11 in Zhengzhou city[J].J Clin Ped Sur,2017,16(6):559-563.DOI:10.3969/j.issn.1671-6353.2017.06.008.
6 沈茜,刘小梅,姚勇,等.中国儿童单症状性夜遗尿疾病管理专家共识[J].临床儿科杂志,2014,32(10):970-975.DOI:10.3969/j.issn.1000-3606.2014.10.019. Shen Q,Liu XM,Yao Y,et al.Expert consensus on management of monosymptomatic nocturnal enuresis in Chinese children[J].Journal of Clinical Pediatrics,2014,32(10):970-975.DOI:10.3969/j.issn.1000-3606.2014.10.019.
7 Yeung CK,Sreedhar B,Sihoe JDY,et al.Differences in characteristics of nocturnal enuresis between children and adolescents:a critical appraisal from a large epidemiological study[J].BJU international,2006,97(5):1069-1073.DOI:10.1111/j.1464-410x.2006.06074.x.
8 邢栋.婴幼儿与学龄前儿童排尿异常的诊断与治疗进展[J].临床小儿外科杂志,2018,17(7):489-491.DOI:10.3969/j.issn.1671-6353.2018.07.003. Xing D.Diagnosis and treatment of urinary abnormalities in infants and preschool children[J].J Clin Ped Sur,2018,17(7):489-491.DOI:10.3969/j.issn.1671-6353.2018.07.003.
9 OhtomoY.Pathophysiology and treatment of enuresis:Focus on sleep[J].Pediatr Int,2018,60(11):997.DOI:10.1111/ped.13707.
10 傅昱.儿童遗尿症的发病机制研究进展[J].国际儿科学杂志,2019,46(4):289-293.DOI:10.3760/cma.j.issn.1673-4408.2019.04.014. Fu Y.Progress in the pathogenesis of pediatric enuresis[J].International Journal of Pediatrics,2019,46(4):289-293.DOI:10.3760/cma.j.issn.1673-4408.2019.04.014.
11 林国模,潘晓芬,李正然,等.儿童遗尿症的相关因素调查[J].海南医学,2019,30(10):127-129.DOI:10.3969/j.issn.1003-6350.2019.10.035. Lin GM,Pan XF,Li ZR,et al.Relevant factors of enuresis in children[J].Hainan Medical Journal,2019,30(10):127-129.DOI:10.3969/j.issn.1003-6350.2019.10.035.
12 潘晓芬,刘玉玲,付四毛,等.原发性遗尿症儿童功能性膀胱容量与遗尿程度的相关性[J].中国妇幼健康研究,2016,27(5):571-573.DOI:10.3969/j.issn.1673-5293.2016.05.007. Pan XF,Liu YL,Fu SM,et al.Correlation between functional bladder capacity and severity of nocturnal enuresis among children with primary enuresis[J].Chinese Journal of Woman & Child Health Research,2016,27(5):571-573.DOI:10.3969/j.issn.1673-5293.2016.05.007.
13 唐海铭.成都地区儿童青少年遗尿症流行病学调查及相关因素分析[D].重庆医科大学,2018. Tang HM.Epidemiological survey of nocturnal enuresis and its related factors in school children in Chengdu[D].Chongqing Medical University,2018.
14 赵波,毕欣,杨米凤,等.云南省多民族儿童夜遗尿症的流行病学调查[J].中国当代医药,2018,25(36):150-152.DOI:10.3969/j.issn.1674-4721.2018.36.047. Zhao B,Bi X,Yang MF,et al.Epidemiological investigation of multi-ethnic children with nocturnal enuresis in Yunnan Province[J].China Modern Medicine,2018,25(36):150-152.DOI:10.3969/j.issn.1674-4721.2018.36.047.
15 McGrath KH,Caldwell PH,Jones MP.The frequency of constipation in children with nocturnal enuresis:a comparison with parental reporting[J].J Paediatr Child Health,2007,44(1-2):19-27.DOI:10.1111/j.1440-1754.2007.01207.x.
16 Nevéus T.Pathogenesis of enuresis:Towards a new understanding[J].International Journal of Urology,2017,24(3):174-182.DOI:10.1111/iju.13310.
17 文建国,王庆伟,文建军,等.411例遗尿症儿童和青少年的家族史和家系分析[J].中华泌尿外科杂志,2007,28(5):316-318.DOI:10.3760/j:issn:1000-6702.2007.05.008. Wen JG,Wang QW,Wen JJ,et al.Family and segregation studies of 411 Chinese children with nocturnal enuresis[J].Chinese Journal of Urology,2007,28(5):316-318.DOI:10.3760/j:issn:1000-6702.2007.05.008.
18 Yu B,Chang N,Lu Y,et al.Effect of DRD4 receptor 616-C/G polymorphism on brain structure and functional connectivity density in pediatric primary nocturnal enuresis patients[J].Sci Rep,2017,7(1):1226.DOI:10.1038/s41598-017-01403-1.
相似文献/References:
[1]王钏宇,贾智明,朱文,等.严重与非严重原发性单症状性夜遗尿症患儿静息态磁共振局部一致性研究[J].临床小儿外科杂志,2022,21(04):347.[doi:10.3760/cma.j.cn101785-202110026-010]
Wang Chuanyu,Jia Zhiming,Zhu Wen,et al.Regional homogeneity in children with severe and non-severe primary monosymptomatic nocturnal enuresis using resting-state functional magnetic resonance imaging[J].Journal of Clinical Pediatric Surgery,2022,21(06):347.[doi:10.3760/cma.j.cn101785-202110026-010]
备注/Memo
收稿日期:2019-12-27;。
基金项目:四川省卫健委普及应用项目（编号：20PJ021）
通讯作者:徐小凤,Email:1037024235@qq.com