遗尿症的生理心理治疗模式

Clinical model of physio-psychological therapy for enuresis

【目的】 建立遗尿症的生理心理治疗模式 ,评估其可行性及有效性。 【方法】 42例遗尿症儿童排除器质性疾病及泌尿生殖系统畸形 ,其中男 2 3例 ,女 19例 ,年龄为 5～ 10岁。采用报警器、行为治疗、膀胱括约肌训练和父母咨询等生理心理治疗方法。 【结果】 ① 42例儿童中 ,2 1人坚持治疗随访 19周 ,遗尿消失 ,有效率为5 0 %;16人半途而废 ,放弃治疗 ,占 3 8.1%;5人虽经 19周治疗 ,但遗尿不消失 ,占 11%。后二者均列入无效组 ,作统计分析。②单因素和多因素统计结果表明 ,用该模式治疗随访 ,时间愈长 ,有效率愈高。③夜间遗尿高峰时间发生在凌晨 2～ 3时 ,女性遗尿儿童当报警声响起时 ,较男性儿童易醒 ,且遗尿消失现象发生在 14～ 16周 (男性在 17～ 19周 ) ,但是男性的有效率明显高于女性。 【结论】 该生理心理治疗模式在临床中是可行的 ,但需要调整非技术性的操作策略 ,提高随访率 。

To set up the clinical model of physio psychological model for enuresis and to evaluate the feasibility and effect of this model. 42 enuretic children excluded organic diseases or uro-genital deformities were choosed in the study. There were 23 boys, 19 girls, age range 5 to 10 years old. The physio psychological treatment was included the enuresis alarm, behavioral therapy, bladder sphincter training and parents' counselling. ①Among 42 enuretic children, 21 patients insisted treatment and followed up 19 weeks. The enuresis was recovered and the success rate was 50%, 16 patients droped off during the treatment(38.1%), among 5 patients still had enuresis after 19 weeks treatment(11.9%). Then we put the latter two types of patients together as unsuccess group, compared with the success patient as another group.②The statistics results by the single factor and multifactors analysis showed that the longer the treatment of this clinical model , the higher the success rate of enuresis.③The peak time of nocturnal enuresis was the 2～3 am. Although the female patients were easier to wake up when the alarm made round and the enuresis was early to disppear(14～16weeks) compared to the male patients (17～19 weeks), the success rate of the male patients was higher than female's. [Conclusion] This clinical model is feasible in the clinics, but it needs to modify by the non technical strategies. After words, it will rise the rate of follow up and further improve the efficient rate of the clinical treatment.