de Moor Jan H M, Frielink Noud, Roijen L E G Ruud
St Radboud Universiteit, Afd. Kinderrevalidatie, Nijmegen, the Netherlands.
Ned Tijdschr Geneeskd. 2010;154:A1580.
A 12-year-old boy with hemiparesis, severe mental retardation, reduced mobility and behavioural problems was not yet toilet trained. He was successfully trained using a behavioural treatment. The training program was based on gradual prolongation of urine retention, the introduction of behaviour restrictions, rewards for using the toilet and overcorrection using repeated exercises if diurnal enuresis occurred. A third of 4- to 18-year-olds with a cerebral palsy do not have diurnal bladder control at the age of 6, in contrast to 1-3% in the general population. An important cause of this difference is the believe that bladder control is dependent on the time of development of bladder control muscles and that it cannot be affected by external methods. This case study shows that even in a relatively older and severely and multiply disabled boy diurnal enuresis can be solved.
一名患有偏瘫、严重智力障碍、行动能力下降和行为问题的12岁男孩尚未接受如厕训练。通过行为疗法，他成功完成了训练。该训练计划基于逐渐延长尿液潴留时间、引入行为限制、对使用厕所给予奖励以及如果发生日间遗尿则通过重复练习进行过度矫正。与普通人群中1%-3%的比例相比，三分之一的4至18岁脑瘫患者在6岁时没有日间膀胱控制能力。造成这种差异的一个重要原因是人们认为膀胱控制取决于膀胱控制肌肉的发育时间，并且不能受到外部方法的影响。本案例研究表明，即使是在一个年龄相对较大、严重且多重残疾的男孩身上，日间遗尿问题也可以得到解决。
