Hua Chaoyang,Wang Xizheng,Ma Yuan,et al.The survey analysis of voiding training in infants on the voiding dysfunction in children[J].Journal of Clinical Pediatric Surgery,2019,18(11):948-952.[doi:10.3969/j.issn.1671—6353.2019.11.010]
婴幼儿排尿训练对儿童排尿异常的影响调查分析
- Title:
- The survey analysis of voiding training in infants on the voiding dysfunction in children
- Keywords:
- Voiding Training; urinary Incontinence; Nocturnal Enuresis; Child
- 分类号:
- R726.9;R694+.53
- 摘要:
- 目的 调查分析婴幼儿排尿训练对儿童排尿异常的影响。方法 采用无记名问卷调查形式，遵循随机化原则对河南、深圳等省市幼儿园和小学的3~12岁儿童进行回顾性调查。按小儿出生后开始排尿训练的时间分为三组：A组≤ 12月龄、B组12~18月龄、C组18~30月龄，比较每组≥ 3岁儿童日间尿失禁和≥ 5岁儿童夜间遗尿的发生率。结果 实际发放调查问卷15 010份，有效问卷11 410份，问卷有效应答率为76.02%。日间尿失禁和夜间遗尿总体发生率分别为7.84%和10.66%。其中，日间尿失禁和夜间遗尿的发生率分别为：A组6.82%和8.69%、B组9.62%和14.34%、C组10.54%和16.55%。A组排尿异常的发生率显著低于B、C两组（P<0.05）。出生12个月之后开始接受排尿训练的婴幼儿长大后发生排尿异常的风险显著增高（P<0.05）。结论 婴幼儿在出生后12个月之内开始接受把尿训练，能有效减少儿童期排尿异常的发生。
- Abstract:
- Objective To explore the effect of voiding training on voiding dysfunction in infants.Methods Through anonymous questionnaires,children aged from 3 to 12 months were surveyed retrospectively and randomly at kindergartens and primary schools from Henan Province and Shenzhen Municipality.According to the postnatal beginning time of voiding training,children were divided into group A ≤ 12 months,group B 12~18 months and group C 18~30 months.The prevalence of daytime urinary incontinence (DUI,aged ≥ 3 years) or nocturnal enuresis (NE,aged ≥ 5 years) was compared among 3 groups.Results A total of 15,010 questionnaires were distributed actually and there were 11,410 valid questionnaires with an effective response rate of 76.02%.The prevalence of DUI and NE was 7.84% (894/11 410) and 10.66% (1 060/9 940) respectively,whereas the prevalence 6.82% & 8.69%,9.62% & 14.34% and 10.54% & 16.55% in groups A,B and C respectively.In group A,the prevalence of voiding dysfunction was significantly lower than that of other two groups (P<0.05).As compared with infants beginning voiding training later than 12 months,the risks of voiding dysfunction were significantly higher than those earlier than 12 months.Conclusion Voiding training earlier than 12 months is beneficial for developing voiding management and minimizing the occurrence of voiding dysfunction in infants.
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 Jansson UB,Hanson M,Sillén U,et al.Voiding pattern and acquisition of bladder control from birth to age 6 years-a longitudinal study[J].J Urol,2005,174(1):289-293.DOI:10.1097/01.ju.0000161216.45653.e3.
3 Fergusson DM,Horwood LJ,Shannon FT.Factors related to the age of attainment of nighttime bladder control:an 8-year longitudinal study[J].Pediatrics,1986,78(5):884-890.
4 Joinson C,Heron J,Von Gontard A,et al.A prospective study of age at initiation of toilet training and subsequent daytime bladder control in school-age children[J].J Dev Behav Pediatr,2009,30(5):385-393.
5 T Berry Brazelton.A child-oriented approach to toilet training[J].Pediatrics,1962,29(2):121-128.
6 Mota DM,Barros AJ.Toilet training:Methods,parental expectations and associated dysfunctions[J].J Pediatr (Rio J) 2008,84(1):9-17.DOI:DOI:10.2223/JPED.1752.
7 Zotter H,Grossauer K,Reiterer F.Is bladder voiding in sleeping preterm infants accompanied by arousals?[J].Sleep Med,2008,9(2):137-141.DOI:10.1016/j.sleep.2007.03.017.
8 Drake MJ,Fowler CJ,Griffiths D,et al.Neural control of the lower urinary and gastrointestinal tracts:supraspinal CNS mechanisms[J].Neurourol Urodyn,2010,29(1):119-127.DOI:10.1002/nau.20841.
9 Zotter H,Sauseng W,Urlesberger B,et al.Does bladder voiding during sleep and wakefulness change the behavioural state of infants?[J]. Acta Paediatr,2006,95(12):1644-1647.DOI:10.1080/08035250600719705.
10 Sillen U.Bladder function in healthy neonates and its development during infancy[J].J Urol,2001,166:2376e81.
11 Blum NJ,Taubman B,Nemeth N.Why is toilet training occurring at older ages? A study of factors associated with later training[J].J Pediatr,2004,145(1):107-111.DOI:10.1016/j.jpeds.2004.02.022.
12 Glicklich LB.An historical account of enuresis[J].Pediatrics,1951,8(6):859-876.
13 Huschka,Mabel.The child’s response to coercive bowel training[J].Psychosomatic Medicine,1942,4(3):301-308.
14 Prugh,Dane G.Childhood experience and colonic disorder[J].Annals of the New York Academy of Sciences,1954,58(4):355-376.
15 Baird,Henry W.Diseases of the nervous system in infancy,childhood and adolescence[M]//Diseases of the nervous system in infancy,childhood and adolescence.Thomas,1952.
16 Toilet Training Guidelines.Parents-the role of the parents in toilet training[J].Pediatrics,1999,103(10):1362-1363.
17 Hellstr?m AL.Influence of potty training habits on dysfunctional bladder in children[J].Lancet,2000,356(9244):1787.DOI:10.1016/S0140-6736(00)03228-1.
18 Bakker E,Wyndaele JJ.Changes in the toilet training of children during the last 60 years:The cause of an increase in lower urinary tract dysfunction?[J].BJU Int,2000,86(3):248-252.DOI:10.1046/j.1464-410x.2000.00737.x.
19 Joinson C,Heron J,Von Gontard A,et al.A prospective study of age at initiation of toilet training and subsequent daytime bladder control in school-age children[J].J Dev Behav Pediatr,2009,30(5):385-393.
20 Duong TH,Jansson UB,Holmdahl G,et al.Development of bladder control in the first year of life in children who are potty trained early[J].J Pediatr Urol,2010,6(6):501-505.DOI:10.1016/j.jpurol.2009.11.002.
21 Wen JG,Wang QW,Chen Y,et al.An epidemiological study of primary nocturnal enuresis in Chinese children and adolescents[J].European Urology,2006,49(6):1107-1113.DOI:10.1016/j.eururo.2005.11.011.
22 Yang SS,Zhao LL,Chang SJ.Early initiation of toilet training for urine was associated with early urinary continence and does not appear to be associated with bladder dysfunction[J].Neurourol Urodyn,2011,30(7):1253-1257.DOI:10.1002/nau.20982.
23 刘惠.尿不湿,用还是不用[J].中国健康月刊,2007,8(1):48-49. Liu H.Diapers,using or not using[J].China Health Monthly,2007,8(1):48-49.
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备注/Memo
收稿日期:2018-05-31。
基金项目:国家自然科学基金（编号：81670689）；河南省科技厅国际合作重点项目（编号：182102410002）
通讯作者:文建国,Email:wenjg@hotmail.com