儿童日间尿失禁流行病学调查及尿不湿的应用对其影响分析

Epidemiological investigation and analysis of the effect of using diapers on daytime urinary incontinence on children

目的调查出生后尿不湿的使用对儿童日间尿失禁（DUI）发生率的影响。方法对我国现阶段3-10岁儿童DUI及儿童出生后尿不湿使用等相关情况进行调查，选取河南省6个城市的30所幼儿园和小学的8900名儿童，采用无记名调查问卷的方式进行分层抽样调查。结果回收有效调查问卷8560份（回收率96．2％）。DUI总体发病率为3．52％，DUI发病率随年龄增长而减低（x2trend=75．690，P〈0．001），从3岁时的6．06％下降到10岁时的1．82％。随着尿不湿使用时间延长，把尿率呈明显降低趋势（x2trend=84．260，P〈0．001），而DUI发生率则呈显著增高趋势（χtrend^2=18．824，P〈0．001）。随着尿不湿使用频率的增加，DUI发生率逐渐增高（χtrend^2=9．234，P〈0．01）。随着把尿训练开始时间的推迟，DUI发生率逐渐增高（χtrend^2=9．775，P〈0．01）。多因素分析显示，尿不湿使用时间延长会增加儿童DUI的发病率（OR=1．017，95％CI：1．006-1．027，P〈0．01），尿不湿使用频率增加会增加儿童DUI的发病率（OR=1．290，95％CI：1．002-1．025，P〈0．05），0-6个月开始把尿训练是儿童DUI的保护因素（OR=0．529，95％CI：0．345-0．811，P〈0．01）。结论尿不湿的使用是3-10岁儿童发生DUI的危险因素，及早开始把尿训练有助于降低儿童DUI的发生率。

Objective To investigate the relationship between the incidence of daytime urinary incontinence（ DUI ） and the usage of diapers. Methods The stratified sampling method was used to investigate the relationship between the incidence of DUI and the usage of diapers on children from 3 to 10 years old from 30 kindergarten and primary schools in Henan Province, China. The survey was carried out in the way of anonymous questionnaire. Results A total of 8 560 qualified questionnaires （96. 2% ） were collected and used for statistical analysis. The overall incidence of DUI was 3.52%. With the age increasing, the incidence of DUI was decreased （ x2trend = 75. 690, P 〈 0. 001 ） from 6. 06% for 3 years old children to 1.82% for 10 years old children. With the time of usage diapers increased, the rate of urination training was significantly reduced（ χtrend^2 = 84. 260, P 〈 0. 001 ） , and the incidence of DUI was significantly increased（ χtrend^2 = 18. 824,P 〈 0. 001 ）. With the increase of using diapers, the incidence of DUI increased （χtrend^2 = 9. 234, P 〈 0. 01 ）. With the delay of the starting time of urination training, the incidence of DUI was increasing（ χtrend^2 = 9. 775, P 〈 0. 01 ）. Logistic regression analysis showed that the increase of time of using diapers（ OR = 1. 017,95% CI： 1. 006 - 1. 027 ,P 〈 0. 01 ） and the increase of frequency of using diapers （ OR = 1. 290,95% CI： 1. 002 - 1. 025, P 〈 0. 05 ） contribute to DUI significantly. Urination training starts from 0 to 6 months was a protective factor against DUI （ OR = 0. 529,95% CI：0. 345 - 0. 811, P 〈 0. 01 ）. Conclusions The usage of diapers is the risk factor of DUI. It＇s better to start urination training earlier to help reduce the incidence of DUI in children.