Yu Jiating,Zhang Yanping,Wang Yihe,et al.Investigation and analysis of incidence and related factors of disposable diaper dependence[J].Journal of Clinical Pediatric Surgery,2022,21(12):1147-1152.[doi:10.3760/cma.j.cn101785-202110015-009]
尿不湿依赖发生率的现况调查及影响因素分析
- Title:
- Investigation and analysis of incidence and related factors of disposable diaper dependence
- 摘要:
- 目的 调查2~6岁儿童尿不湿依赖(disposable diaper dependence,DDD)的发生率,并探讨其相关因素。方法 遵循随机化原则选取2016年10月至2017年12月郑州市、深圳市、太原市及厦门市的32所幼儿园中2~6岁幼儿和儿童进行横断面研究,通过匿名问卷的形式调查幼儿和儿童及其家属的社会人口学特征、儿童DDD情况及生活质量,分析儿童DDD的危险因素。研究对象纳入标准为2岁以上儿童仍然依赖尿不湿,日间不能自主控制大便和(或)小便,病史调查和体格检查未发现神经系统或泌尿系统器质性病变。 结果 实际发放调查问卷7 850份,回收合格问卷6 887份,问卷有效应答率为87.73%(6 887/7 850)。DDD发生率为3.75%(258/6 887),其中男性发生率3.60%(129/3 582),女性发生率为3.90%(129/3 305),不同性别之间发生率差异无统计学意义(P＞0.05)。DDD发生率随年龄增长而逐渐降低,从2岁时的8.64%下降至6岁时的0.80%(χ2trend=134.164,P＜0.001)。开始排尿训练的时间越晚,DDD发生率越高(χ2trend=90.559,P＜0.001)。多因素Logistic回归分析显示,城市儿童DDD的发生率比农村儿童高,未进行排尿训练是儿童发生DDD的危险因素(P＜0.05),12月龄前开始排尿训练是儿童DDD的保护因素(0~6月龄:OR=0.271,95%CI= 0.175~0.418,P＜0.001;7~12月龄:OR=0.394,95%CI=0.263~0.591,P＜0.001)。结论 婴幼儿DDD多见,未及时进行排尿训练是其主要危险因素,早期开始排尿训练有助于降低儿童DDD的发生率。
- Abstract:
- Objective To explore the incidence and risk factors of disposable diaper dependence (DDD) in children aged 2~6 years.Methods Kindergarten children aged 2-6 years were selected randomly and cross-sectionally from 4 domestic cities of Zhengzhou,Taiyuan,Shenzhen and Xiamen.The sociodemographic characteristics,DDD incidence and quality-of-life of children and their families were surveyed by an anonymous questionnaire and the risk factors affecting DDD analyzed.The inclusion criteria of DDD referred to children aged over 2 years dependent on disposable diaper,unable to control defecation and/or urination during day and no organic lesions such as nerve and urinary system through medical history taking and physical examinations.Results A total of 7 850 questionnaires were distributed with an effective response rate of 87.73%(6 887/7 850).The incidence of DDD was 3.75%(258/6 887)(3.60% in boy and 3.90% in girl).No significant difference existed between different genders (P>0.05).The incidence of DDD declined gradually with age from 8.64% at 2 years to 0.80% at 6 years (χ2trend=134.164,P<0.001).The later start time of voiding training,the higher incidence of DDD (χ2trend=90.559,P<0.001).Multivariate Logistic regression analysis revealed that the incidence of DDD was higher in urban children than that in rural counterparts.Non-voiding training was a risk factor for DDD in children (P<0.05).Starting voiding training prior to 12 months was a protective factor for children (0~6 months:OR=0.271,95%CI=0.175-0.418,P<0.001;7 to 12 months of age:OR=0.394,95%CI=0.263-0.591,P<0.001).Conclusion DDD is common in children.Failure to voiding training in time is a major risk factor of DDD.Early voiding training helps to lower the incidence of DDD in children.
参考文献/References:
[1] 李颖.纸尿裤普及市场庞大[J].中国质量万里行,2018,310(12):69-70.Li Y.Huge market for disposable diapers[J].China Quality Miles,2018,310(12):69-70.
[2] 李一冬,王一鹤,杨静,等.幼儿尿不湿依赖86例临床特征和治疗效果分析[J].现代泌尿外科杂志,2021,26(8):651-654.DOI:10.3969/j.issn.1009-8291.2021.08.005.Li YD,Wang YH,Yang J,et al.Effects of toilet training on 86 young children with disposable diaper dependence[J].Journal of Modern Urology,2021,26(8):651-654.DOI:10.3969/j.issn.1009-8291.2021.08.005.
[3] Wang XZ,Wen YB,Shang XP,et al.The influence of delay elimination communication on the prevalence of primary nocturnal enuresis-a survey from Mainland China[J].Neurourol Urodyn,2019,38(5):1423-1429.DOI:10.1002/nau.24002.
[4] 江曼霞.全球视角下的中国婴儿纸尿裤市场——机遇与挑战并存[J].生活用纸,2016,16(3):17-19.Jiang MX.Chinese Baby Diaper Market with global perspectives:opportunities and challenges[J].Tissue Paper & Disposable Products,2016,16(3):17-19.
[5] Ahmed JU,Majid MA,Suhaila S,et al.Bashundhara Baby diaper marketing strategies in Bangladesh[J].Bus Perspect Res,2020,8(2):308-323.DOI:10.1177/2278533719887459.
[6] Krafchik B.History of diapers and diapering[J].Int J Dermatol,2016,55(Suppl 1):4-6.DOI:10.1111/ijd.13352.
[7] Thaman LA,Eichenfield LF.Diapering habits:a global perspective[J].Pediatr Dermatol,2014,31(Suppl 1):15-18.DOI:10.1111/pde.12468.
[8] 杨静,邢栋,文建国,等.2~3岁幼儿日间尿失禁与其使用一次性尿布和排尿训练的相关性研究[J].中华护理教育,2020,17(12):1119-1123.DOI:10.3761/j.issn.1672-9234.2020.12.013.Yang J,Xing D,Wen JG,et al.The effects of disposable diaper and elimination communication on daytime urination incontinence in children aged 2 to 3 years[J].Chinese Journal of Nursing Education,2020,17(12):1119-1123.DOI:10.3761/j.issn.1672-9234.2020.12.013.
[9] 王一鹤,时伟,汪玺正,等.儿童婴幼儿期尿不湿使用及对排尿控制的影响研究[J].临床小儿外科杂志,2021,20(5):441-446.DOI:10.12260/lcxewkzz.2021.05.009.Wang YH,Shi W,Wang XZ,et al.Survey of using disposable diaper in infants and toddlers aged under 6 years and its impact on urination control[J].J Clin Ped Sur,2021,20(5):441-446.DOI:10.12260/lcxewkzz.2021.05.009.
[10] 李延伟,文一博,王一鹤,等.河南省农村儿童与城市儿童夜遗尿患病率及影响因素的调查研究[J].临床小儿外科杂志,2019,18(10):844-848.DOI:10.3969/j.issn.1671-6353.2019.10.009.Li YW,Wen YB,Wang YH,et al.Incidence of primary nocturnal enuresis and related influencing factors in children of rural and urban areas in Henan Province[J].J Clin Ped Sur,2019,18(10):844-848.DOI:10.3969/j.issn.1671-6353.2019.10.009.
[11] Zhang YS,Huang CX,Wen JG,et al.Relationship between brain activity and voiding patterns in healthy preterm neonates[J].J Pediatr Urol,2016,12(2):113.e1-e6.DOI:10.1016/j.jpurol.2015.10.004.
[12] Wen JG,Lu YT,Cui LG,et al.Bladder function development and its urodynamic evaluation in neonates and infants less than 2 years old[J].Neurourol Urodyn,2015,34(6):554-560.DOI:10.1002/nau.22626.
[13] Xing D,Wang YH,Wen YB,et al.Prevalence and risk factors of overactive bladder in chinese children:a population-based study[J].Neurourol Urodyn,2020,39(2):688-694.DOI:10.1002/nau.24251.
[14] Restrepo D.Urinary tract infection:a prevalent problem in Pediatrics[J].Bol Med Hosp Infant Mex,2017,74(4):241.DOI:10.1016/j.bmhimx.2017.06.001.
[15] Foxman B.Urinary tract infection syndromes:occurrence,recurrence,bacteriology,risk factors and disease burden[J].Infect Dis Clin North Am,2014,28(1):1-13.DOI:10.1016/j.idc.2013.09.003.
[16] Khan A,Jhaveri R,Seed PC,et al.Update on associated risk factors,diagnosis,and management of recurrent urinary tract infections in children[J].J Pediatric Infect Dis Soc,2019,8(2):152-159.DOI:10.1093/jpids/piy065.
[17] Sugimura T,Tananari Y,Ozaki Y,et al.Association between the frequency of disposable diaper changing and urinary tract infection in infants[J].Clin Pediatr (Phila),2009,48(1):18-20.DOI:10.1177/0009922808320696.
[18] Rakoczy G,Brown B,Barman D,et al.KTP laser:an important tool in refractory recurrent tracheo-esophageal fistula in children[J].Int J Pediatr Otorhinolaryngol,2010,74(3):326-327.DOI:10.1016/j.ijporl.2009.12.009.
[19] Carr AN,Dewitt T,Cork MJ,et al.Diaper dermatitis prevalence and severity:global perspective on the impact of caregiver behavior[J].Pediatr Dermatol,2020,37(1):130-136.DOI:10.1016/j.ijporl.2009.12.009.
[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(5):501-505.DOI:10.1016/j.jpurol.2009.11.002.
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备注/Memo
收稿日期:2021-10-14。
基金项目:国家自然科学基金委员会联合基金项目(U1904208)
通讯作者:文建国,Email:wenjg@hotmail.com