中国实用儿科杂志

中国实用儿科杂志

• 论著 • 上一篇    下一篇

遗尿报警器治疗学龄前儿童原发性单症状性夜遗尿症的临床研究（附95例报告）

  

  1. 1.首都儿科研究所附属儿童医院 肾脏内科，北京 100020；2.首都医科大学附属北京儿童医院， 北京100045
  • 出版日期:2019-11-06 发布日期:2019-12-03

Enuresis alarm therapy for preschool children with primary monosymptomatic nocturnal enuresis: A report of 95 cases

  1. *Department of Nephrology，Affiliated Children’s Hospital of Capital Institute of Pediatrics，Beijing  100020，China
  • Online:2019-11-06 Published:2019-12-03

摘要： 目的　探讨遗尿报警器治疗学龄前儿童原发性单症状性夜遗尿症的疗效。方法　选取2017年1月至2018年7月在首都儿科研究所附属儿童医院收治的中重度原发性单症状性夜遗尿症患儿95例，年龄3.5～6.0岁。按照随机分组的方法，其中治疗组53例采用遗尿报警器治疗，对照组42例采用基础治疗。治疗3个月或达到连续干床14d（治疗成功）停止。治疗成功者停止治疗1个月，记录复发例数。重新报警器治疗3个月，观察疗效。结果　治疗组7例（13.2%）未达疗程退出，余46例中治疗完全有效（FR）29例，部分有效（PR）7例，治疗无效（NR）10例。其中FR组25例治疗成功，治疗成功所需疗程最短42d。治疗成功者停止治疗1个月，复发例数11例。8例重新使用报警器治疗3个月，均可达到治疗完全有效。对照组3例（7.1%）失访，39例观察3个月，均未达到连续干床14 d。对照组FR 0例，PR 17例，NR 22例。两组治疗完全有效率采用Fisher精确概率法检验，差异有统计学意义（χ2＝55.10，P＝0.00）。报警器治疗NR组，5例（50%）患儿年龄＜4岁，而FR+PR组，仅有3例（8.3%）年龄＜4岁，采用P earson卡方检验，差异有统计学意义（χ2＝9.457，P＝0.007）。入组患儿均未发现严重不良反应。结论　遗尿报警器治疗学龄前儿童原发性单症状性夜遗尿症患儿安全、 有效，报警器干预的年龄以4岁以上为宜。报警器是逐渐起效的，获得成功治疗的时间＞1个月。

关键词: 儿童, 原发性单症状性夜遗尿症, 遗尿报警器, 治疗

Abstract: Objective　To explore the effectiveness of enuresis alarm therapy on preschool children with primary monosymptomatic nocturnal enuresis（PMNE）. Methods　Totally 95 PMNE preschool children aged 3.5 to 6 years admitted between January 2017 and July 2018 to Department of Nephrology，Affiliated Children’s Hospital of Capital Institute of Pediatrics，were  randomly divided into two groups：alarm group（53 cases） and control group（42 cases）. The alarm group was managed by enuresis alarm therapy，while the control group received basic treatment. Treatment ceased after 12 weeks of training or when the cases achieved 14 consecutive dry nights（meaning successful treatment）. The relapse cases were recorded 1 month after stopping treatment. The alarm therapy was performed again in the relapse cases for another course. Results　Seven cases（13.2%） discontinued intervention in the alarm group. The response of the alarm therapy in the remaining 46 patients was as follows：full response（FR） in 29 cases（63.0%），partial response（PR）in 7 cases（15.2%），no response（NR） in 10 cases（21.7%）. A total of 25 patients achieved 14 consecutive dry nights in FR cases. Successful treatment requires a minimum course of treatment for 42 days. Relapse occurred in 11 cases within the first 1 month after stopping treatment，and 8 relapse patients responded to another course of alarm therapy. Three cases（7.1%） lost to follow-up in the control group. The response of the control group in the remaining 39 patients was as follows：FR in 0 case，PR in 17 cases（43.6%） and NR in 22 cases（56.4%）. No cases achieved successful treatment in the control group. The full response rate was significantly different between two groups（Fisher’s exact test χ2＝55.10，P＝0.00）. Half（5 cases） of NR patients were less than 4 years old，while in the FR+PR patients，the percentage of children under 4 years old was only 8.3%（3 cases） in alarm therapy group（Pearson chi-square test，χ2＝9.457，P＝0.007）. No severe adverse events occurred in all cases. Conclusion　Enuresis alarm therapy is a safe and effective way to treat PMNE preschool children. The enuresis alarm provided gradual effects and require more than 1 month in achieving successful effect. The appropriate age for alarm treatment is over four years old.

Key words: child, primary monosymptomatic nocturnal enuresis, enuresis alarm, therapy