下尿路功能障碍患儿的临床特征及心理行为分析

Clinical characteristics and psycho-behavioral analysis of children with lower urinary tract dysfunction

目的总结分析下尿路功能障碍(LUTD)患儿的临床及心理行为特征,为临床的精确诊断和个性化治疗提供参考依据。方法回顾性分析四川大学华西医院于2020年7月—2021年10月就诊的382例排尿异常患儿的病情询问表、儿童行为量表及自我意识量表,对LUTD患儿相关临床特征和心理行为特征进行分析。结果382例下尿路功能障碍患儿中,男性256例,女性126例;平均年龄(6.79±2.51)岁;有夜间尿床症状者265例,日间漏尿194例,尿频症状153例,尿急症状264例,特殊姿势排尿为89例,间断排尿症状44例,就诊时伴泌尿系感染者26例;主诉有排便异常82例,其中便秘55例,粪污27例。Achenbach儿童行为量表评分中,6~11岁组患儿行为学问题发生率最高(28.7%),日间漏尿组得分(37.09±19.32)分显著高于无日间漏尿组得分(23.81±15.96)分(t=4.978,P<0.05)。下尿路功能障碍患儿自我意识总分为(52.49±12.15)分;行为、智力与学校、躯体外貌、焦虑、合群、幸福与满足维度得分均较低。日间漏尿组得分(45.14±10.76)分显著低于无日间漏尿组得分(61.76±4.93)分(t=6.564,P<0.05)。结论LUTD患儿的临床表现有广泛的差异性,患儿往往存在较为明显的心理行为问题,6~11岁以及有日间漏尿症状的患儿心理行为问题更为突出。因此,临床医护人员应选择适当的评估工具和方法,进行准确评估和判断,关注患儿的心理行为问题,多学科协作制定治疗方案,以获取最佳治疗效果。

Objective To summarize and analysis the clinical and psycho-behavioral characteristics of lower urinary tract dysfunction(LUTD)in children,and provide a reference for accurate clinical diagnosis and personalized treatment.Methods The clinical data of 382 children with dysuria treated in West China Hospital of Sichuan University from July 2020 to October 2021 were retrospectively analyzed,and the relevant clinical features and psych behavioral characteristics of children with LUTD were analyzed.Results There were 256 boys and 126 girls in 382 children with lower urinary tract dysfunction.The mean age was(6.79±2.51)years.265 had bed wetting symptoms at night,194 had day-time leakage,153 had frequent micturition symptoms,and 264 had urgency.Among the 382 children,89 had special micturition posture,44 had intermittent micturition symptoms,and 26 had urinary tract infection.Among the 382 children,82 had abnormal defecation,including 55 cases of constipation and 27 cases of fecal dirt.Children aged 6-11 had the highest incidence of behavioral problems(28.7%),the score of the daytime urine leakage group(37.09±19.32)was significantly higher than that of the no daytime urine leakage group(23.81±15.96)(t=4.978,P<0.05).The total score of self-consciousness of children with lower urinary tract dysfunction was(52.49±12.15).The scores of behavior,intelligence and school,physical appearance,anxiety,fit,happiness and satisfaction were all low.The score of the daytime urine leakage group(45.14±10.76)was significantly lower than that of the no daytime urine leakage group(61.76±4.93)(t=6.564,P<0.05).Conclusion The clinical manifestations of LUTD children vary widely.Children often have obvious psychological and behavioral problems,especially those with obvious school age and daytime symptoms.Therefore,clinical doctors and nurses should choose appropriate assessment tools and methods,make accurate assessment and judgment,pay attention to the psychological and behavioral problems of children,and develop treatment plans in multidisciplinary cooperation to obtain the best treatment effect.