256例儿童白天尿频相关因素分析

Analysis of Factors Related to Frequent Daytime Urination in 256 Children

目的总结256例白天尿频患儿发病的相关影响因素,探讨其常见原因和诊治方法。方法单中心回顾性分析2017年1月1日至12月31日中国医科大学附属盛京医院小儿肾脏风湿免疫科门诊接诊的256例白天尿频患儿的发病特点,重点对血IgE升高组与血IgE正常组进行比较,总结患儿白天尿频的相关原因,探讨在不同因素影响下缓解症状的方法。结果 256例白天尿频患儿中,150例血IgE明显升高,其中大部分年龄<7岁,伴有皮肤瘙痒史和便秘史者居多,予口服抗过敏药物并控制高蛋白饮食后,大部分患儿尿频症状明显好转;泌尿系感染15例,予抗炎治疗后症状好转;镜下血尿20例,嗜酸性粒细胞增多2例,均需行进一步检查明确病因;慢性阑尾炎2例,尿道肿瘤1例,已转至小儿外科或自行前往外院治疗;其余65例目前检查未见异常,需进一步观察;失访1例。结论引起儿童白天尿频的首要原因是Ig E介导的尿路黏膜过敏反应,其次为泌尿系感染和镜下血尿。此外,白天尿频患儿应注意全面查体,尤其是腹部、外阴和骶尾部,需结合病史、全面查体和辅助检查后,做出诊断并进一步治疗。

Objective To define the factors leading to frequent daytime urination in 256 children and discuss the common causes and treatment.Methods In all 256 patients,diagnosed with frequent daytime urination at Shengjing Hospital between January 1,2017 and December 31,2017,were retrospectively enrolled in this study.Clinical characteristics,especially a comparison of 2 groups with increased serum IgE level and normal serum IgE level,were analyzed to investigate the causes of frequent daytime urination and identify the methods to relieve symptoms under different conditions.Results A total of 150 patients,aged less than 7 years,had increased serum IgE level,with a concomitant history of itchy skin and constipation.After taking oral anti-allergy drugs and controlling protein intake,frequency of urination in most children improved significantly.Fifteen children were diagnosed with urinary tract infections that were relieved after anti-inflammatory treatment.Twenty cases of microscopic hematuria and two cases of eosinophilic granulocytosis required further investigations to determine the etiology.Two cases of chronic appendicitis and one case of urethral tumor were transferred to another department or hospital for pediatric surgery.Routine examination was required for further observation in 65 cases.One patient was lost to follow-up.Conclusion The main cause for frequent daytime urination was IgE-mediated urethral mucosal allergic reaction,followed by urinary tract infection and microscopic hematuria.Children with frequent daytime urination should be carefully evaluated with a comprehensive physical examination,especially of the abdomen,vulva,and sacrococcygeal region.After a combination of medical history perusal,comprehensive physical examination,and auxiliary examination,the diagnosis and further treatment can be determined.