252例儿童夜遗尿症的临床特征分析

目的调查夜遗尿患者临床特征,帮助医务人员准确判断夜遗尿,避免误诊和漏诊。方法回顾性分析四川大学华西医院2018年6月至2019年2月就诊的252例夜遗尿症患者的临床资料及排尿日记,分析夜遗尿症患者的临床特征。结果252例夜遗尿患者中,单症状夜遗尿患者130例(51.59%),非单症状夜遗尿患者94例(37.30%),膀胱过度活动症28例(11.11%)。出现功能性膀胱容量减少121例(48.02%),夜间多尿51例(20.23%),夜尿多及功能性膀胱容量减少16例(6.35%),夜间尿量和膀胱容量正常64例(25.40%)。夜遗尿儿童临床表现特征排前三位的是难以唤醒、便秘和饮水。儿童夜遗尿遗传因素占14.29%。结论夜遗尿就诊患者中以合并膀胱问题为主,患者最常见的临床特征为夜间睡眠过深、难以唤醒。关注夜遗尿患者的临床特征及排尿日记,正确识别、判断、决策,有助于为夜遗尿患者提供更优质的诊疗服务。

Management of nocturnal enuresis-myths and facts

Nocturnal enuresis often causes considerable distress or functional impairment to patient and their parents necessitating a multidisciplinary approach from paediatrician, paediatric nephrologist, urologists and psychiatrist. Mechanisms of monosymptomatic nocturnal enuresis are mainly nocturnal polyuria, bladder overactivity and failure to awaken from sleep in response to bladder sensations. Goal oriented and etiology wise treatment includes simple behavioral intervention, conditioning alarm regimen and pharmacotherapy with desmopressin, imipramine and anticholinergic drugs. Symptoms often recurs requiring change over or combination of different modes of treatment.