Kroll Paweł, Zachwieja Jacek
Katedra Chirurgii Dzieciecej, Klinika Chirurgii, Traumatologii i Urologii Dzieciecej.
Przegl Lek. 2006;63 Suppl 3:229-32.
The aim of the study was to describe our diagnostic and therapeutic logarithm based on functional classification in children with enuresis, and effects of therapy based on this classification.
we reviewed charts of 123 children managed because of nocturnal enuresis (68 boys, 55 girls, aged 4-18 (mean 7,6) years). Every child had routinely performed ultrasonography, urinalysis, uroflowmetry with estimation of residual urine. Children with urinary tract infections or malformations of the urinary tract were not included in this study. At the first visit all children were instructed to conduct voiding diary. On the base of data from voiding diarys and uroflowmetries children are divided in two groups: Group I (n=21) with monosymptomatic nocturnal enuresis. Group II (n=102) children with bladder dysfunction and enuresis. In the first group rehabilitation program with bladder training, conducting voiding diary and conditioning therapy with alarm device was introduced. In children with bladder dysfunctions therapy started with bladder training and pharmacotherapy of bladder dysfunction.
9 children (6 from Group I and 3 from Group II) started to wake after starting bladder training. 81 children from Group II improved bladder function. 30 children from Group II started to wake up during therapy of bladder dysfunction. In 44 children, who improved bladder function and still had episodes of nocturnal enuresis, therapy with alarm device was introduced. From all 66 children treated with alarm device 5 started to wake up without any one episode of wetting. In 20 children the ability to wake up before alarm started to ring occurred in the first month of therapy. 40 children need to be treated for the second month, in 5 children therapy was prolonged for the third month. 9 children did not learn to wake up for urination. We have 8 drop-outs. In 7 therapy was repeated because of recurrence.
The system of treatment of nocturnal enuresis is effective both in children with monosymptomatic nocturnal enuresis and in children with enuresis and voiding dysfunction.
本研究的目的是描述我们基于遗尿症患儿功能分类的诊断和治疗方案，以及基于该分类的治疗效果。
我们回顾了123例因夜间遗尿症接受治疗的儿童病历（68名男孩，55名女孩，年龄4 - 18岁（平均7.6岁））。每个孩子都常规进行了超声检查、尿液分析、尿流率测定及残余尿量估计。患有尿路感染或泌尿系统畸形的儿童未纳入本研究。首次就诊时，所有孩子都被指导记录排尿日记。根据排尿日记和尿流率测定的数据，将孩子分为两组：第一组（n = 21）为单纯性夜间遗尿症。第二组（n = 102）为膀胱功能障碍合并遗尿症的儿童。第一组采用膀胱训练、记录排尿日记及使用警报装置进行条件治疗的康复方案。对于膀胱功能障碍的儿童，治疗从膀胱训练和膀胱功能障碍的药物治疗开始。
9名儿童（第一组6名，第二组3名）在开始膀胱训练后开始能自行醒来。第二组81名儿童膀胱功能得到改善。第二组30名儿童在膀胱功能障碍治疗期间开始能自行醒来。在44名膀胱功能得到改善但仍有夜间遗尿发作的儿童中，引入了警报装置治疗。在所有66名接受警报装置治疗的儿童中，5名开始能自行醒来且无任何尿床情况。20名儿童在治疗的第一个月就出现了在警报响起前能自行醒来的能力。40名儿童需要接受第二个月的治疗，5名儿童的治疗延长至第三个月。9名儿童未学会自行醒来排尿。我们有8名退出治疗者。7名儿童因复发而重复治疗。
夜间遗尿症的治疗方案对于单纯性夜间遗尿症儿童以及遗尿症合并排尿功能障碍的儿童均有效。
