黄冈市黄州区5～7岁儿童原发性遗尿症及其致心理障碍的流行病学调查分析

Epidemiological investigation and analysis of primary nocturnal enuresis and PNE-induced mental disorders among children aged 5-7 years in Huangzhou District,Huanggang City

目的探讨黄冈市黄州区5~7岁儿童原发性遗尿症(PNE)及其致心理障碍的流行病学,为临床防治儿童原发性遗尿症及其引起的心理障碍提供参考依据。方法 2014年3月-2015年12月采用分层整群抽样方法对黄冈市黄州区13所幼儿园2 580名5~7岁儿童和家长进行调查问卷,了解PEN及其致心理障碍的发病情况。结果剔除无效问卷,共纳入2 418名儿童,511名出现PEN,占21.13%。随着年龄段增长PEN发生率下降,各年龄组PEN发生率比较差异有统计学意义(P<0.05)。511名PEN儿童以夜间遗尿为主(占68.10%),尿床频率以4~7次/周(占36.40%)最高,多数夜间难以唤醒(占74.95%)、夜间从不自行起床排尿(占67.32%),不同年龄组间比较差异均无统计学意义(P>0.05)。265名PEN儿童出现不同程度的心理障碍(占51.86%),以情绪不稳及易冲动(占61.13%)最为常见,其次为自卑及紧张心理(占49.43%)、社交焦虑(占48.68%),且随着年龄段增长心理障碍发生率上升,各年龄组间比较差异有统计学意义(P<0.05)。结论 5~7岁儿童原发性遗尿症发生率较高,但随着年龄增长而下降,夜间排尿、4~7次/周、夜间难以唤醒、夜间从不自行起床排尿的发生率较高,多数会伴随出现心理障碍,且随着年龄增大而上升;临床和家长可从服用药物、心理行为干预等方面预防PEN及其导致的心理障碍发生。

Objective To explore the epidemiology of primary nocturnal enuresis （PNE） and PNE-induced mental disorders in children aged 5-7 years in Huangzhou District, Huanggang City, and to provide references for clinical prevention and treatment of PNE and PNE-induced mental disorders in children. Methods A stratified cluster sampling method was used to select 2,580 children aged 5-7 years in 13 kindergartens in Huangzhou District, Huanggang City from March 2014 and December 2015. A questionnaire survey on the incidence of PEN and PEN-induced mental disorders was conducted. Results After excluding the invalid questionnaires, a total of 2,418 children were enrolled into this study, and 511 （21.13%） had PEN. The incidence rate of PEN decreased with the increase of age, and the differences in the incidence rates of PEN among different age groups showed statistically significant （P〈0.05 ）. The common symptom in the 511 children with PEN was nocturnal enuresis （accounting for 68.10%）. As for the frequency of nocturnal enuresis, 4-7 times per week was the highest （accounting for 36.40%）. Most （74. 95%） of the children were difficult to wake up at night, and children who never got up to urinate at night accounted for 67. 32%. And no statistically significant differences were found among different age groups （P〉0.05）. 265 （51.86% ） PEN chil- dren had various degrees of mental disorders. Emotional instability and impulsive emotion were the most common symptoms （61.13%） , followed by low self-esteem and psychological tension （49.43%） , and social anxiety （48.68%）. The incidence rate of mental disorders increased with the increase of age, and the differences among different age groups showed statistically significant （P〈0.05）. Conclusions The incidence rate of PNE in children aged 5-7 years is relatively higher, but it decreases with the increase of age. The incidence rates of urination at night, nocturnal enuresis 4 to 7 times per week, waking up at night difficultly and never getting up to urinate at night are relatively higher. Most of the PNE children may be complicated by mental disorders, and the incidence rate increases with age. Clinicians and parents can prevent the occurrence of PEN and PEN-induced mental disorders from medication, psychological and behavioral interventions.