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[尿动力学在“遗尿症”诊断与治疗中的应用——对儿童及青少年精神病学的意义]

[Urodynamics in diagnosis and therapy of "enuresis"--relevance for child and adolescent psychiatry].

作者信息

von Gontard A, Güls F, Lehmkuhl G

机构信息

Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universität Köln.

出版信息

Z Kinder Jugendpsychiatr Psychother. 1999 Feb;27(1):47-57. doi: 10.1024//1422-4917.27.1.47.

Abstract

Enuresis and functional urinary incontinence are clinically and pathophysiologically heterogeneous disorders. They differ with regard to their urodynamics, i.e. with regard to the function or dysfunction of the urinary tract. In addition to general measures such as history, physical examination, urinalysis, questionnaires and flow charts, noninvasive sonography and uroflowmetry with pelvic-floor EMG play an important role in diagnosis and therapy. Rates of pathological findings are especially high among day-wetting children and nocturnal enuretics with micturition problems. This group requires a detailed diagnosis, especially children with detrusor-sphincter discoordination, which can be treated effectively by means of uroflow-biofeedback. The relevance of these methods in child and adolescent psychiatry are discussed in detail and practical recommendations are made.

摘要

遗尿症和功能性尿失禁在临床和病理生理方面是异质性疾病。它们在尿动力学方面存在差异,即与尿路的功能或功能障碍有关。除了病史、体格检查、尿液分析、问卷调查和流程图等一般措施外,无创超声检查以及结合盆底肌电图的尿流率测定在诊断和治疗中发挥着重要作用。在日间遗尿儿童和存在排尿问题的夜间遗尿症患者中,病理检查结果的发生率尤其高。这一组患者需要进行详细诊断,尤其是患有逼尿肌-括约肌不协调的儿童,可通过尿流生物反馈进行有效治疗。详细讨论了这些方法在儿童和青少年精神病学中的相关性并给出了实际建议。

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