Bartolozzi G, Boldrini A, Salmeri A, Vitali E
Clinica Pediatrica I, Università di Firenze, Ospedale Meyer, Italia.
Pediatr Med Chir. 1991 Jul-Aug;13(4):389-93.
Enuresis is a common functional problem among children which is defined as a complete involuntary voiding of urine at an age which control should be present. Bed wetting generally resolves with increasing age, but the restriction in social life and the psychological secondary problems, so frequent in older patients, justify an appropriate treatment of the problem in the child over seven. At children's Hospital of Florence University an enuresis service exists since 1983, and during these years 541 children applied to the structure. 326 children completed the treatment, among these there were 202 boy and 124 girls with age between 6 and 19. All the patients have been initially helped only with conversation (motivational counseling) and 76 among them (23% of the whole) obtained permanent cure. The remaining 250 children were treated with the conditioning alarm system, always associated to periodic conversation, urine stop exercises and other psychological support (token economy, etc). There were 161 boys and 89 girls: 220 children had nocturnal primary enuresis and 30 secondary. The family history was positive in 77%. The results obtained of this kind of treatment after a follow-up of 6 months, were permanent recovery in 211 children (84%) and failure in 39 patients (16% of the cases). There have been 35 relaxes. Regarding the sex, no significant difference was noted. These positive results with the conditioning devices favor the view that the etiology of primary enuresis is mainly biologic. The bell alarm represents the most effective treatment for nocturnal enuresis included more than seven.(ABSTRACT TRUNCATED AT 250 WORDS)
遗尿症是儿童中常见的功能性问题,定义为在本应具备控制能力的年龄出现完全不自主的排尿。尿床通常会随着年龄增长而自行缓解,但社会生活受限以及年长患者中常见的心理继发性问题,证明对七岁以上儿童的这一问题进行适当治疗是合理的。自1983年以来,佛罗伦萨大学儿童医院设有遗尿症诊疗服务,这些年里有541名儿童前来该机构就诊。326名儿童完成了治疗,其中有202名男孩和124名女孩,年龄在6至19岁之间。所有患者最初仅通过谈话(动机咨询)得到帮助,其中76人(占总数的23%)获得了永久性治愈。其余250名儿童采用条件报警系统进行治疗,同时始终辅以定期谈话、憋尿练习和其他心理支持(代币法等)。其中有161名男孩和89名女孩:220名儿童患有夜间原发性遗尿症,30名患有继发性遗尿症。77%的患者有家族病史。这种治疗方法在6个月的随访后,结果是211名儿童(84%)永久性康复,39名患者(占病例的16%)治疗失败。有35例复发。在性别方面,未发现显著差异。这些使用条件装置取得的积极结果支持原发性遗尿症的病因主要是生物学因素这一观点。铃铛报警器是治疗七岁以上儿童夜间遗尿症最有效的方法。(摘要截选至250词)