Department of Physical Medicine and Orthopedic Surgery, Ghent University Hospital, Ghent, Belgium -
Department of Urology, Ghent University Hospital, Ghent, Belgium.
Eur J Phys Rehabil Med. 2019 Feb;55(1):40-46. doi: 10.23736/S1973-9087.17.04851-1. Epub 2017 Nov 3.
Little is known about the occurrence of nocturnal polyuria (NP) in spinal cord injured (SCI) patients and the definitions which are preferable in this population.
To determine the occurrence of NP in SCI patients during in-patient rehabilitation in the Ghent University Hospital. To study the influence of different time periods (daytime, bed rest and sleep) on the accuracy of the existing diagnose definitions for NP specifically for this type of patients.
Retrospective study using patient records.
SCI patients during hospital-based rehabilitation between 2011 and 2014.
Seventy-four SCI patients were selected and their records of frequency-volume charts (FVC) were examined, after exclusion of unreliable data, forty-seven patients were retained for the current study.
Retrospective study using data from FVC of either two or three days from patients with SCI. Nocturnal urine production (NUP) and nocturnal polyuria index (NPi) were calculated.
There was a significant increase in diuresis, calculated as urine production, between day time and bed rest (P=0.008) and between day time and sleep (P=0.001). All patients showed NP during a 12-hour night time period (including both bed rest and sleep) and 39 patients showed NP during the 8-hour period of sleep. There was no significant difference in mean urine production between bed rest and sleep. Prevalence of NP did not significantly differ between the complete or incomplete SCI patients or between patients with higher and lower SCI levels.
This study showed that the occurrence of NP in patients with SCI is high and that it is important to consider which definitions of NP are used for diagnosis. Increase in diuresis is observed during bed rest and sleep and the diagnose is correctly estimated when nocturnal urine production definitions are used in both time periods. In accordance with what was expected, diagnose of NP was overestimated when NP index type definitions were used.
It is important to be aware of the frequent-occurrence of NP in SCI patients and the impact of their daily routine to the accuracy of the diagnosis of NP. More knowledge about this topic can help to avoid incontinence caused by nocturnal polyuria.
关于脊髓损伤（SCI）患者夜间多尿（NP）的发生情况以及在该人群中更适合的定义知之甚少。
确定根特大学医院住院康复期间 SCI 患者 NP 的发生情况。研究不同时间段（白天、卧床休息和睡眠）对 NP 现有诊断定义在该类型患者中的准确性的影响。
使用病历的回顾性研究。
2011 年至 2014 年期间在基于医院的康复中的 SCI 患者。
选择了 74 名 SCI 患者，并检查了他们的频率-体积图表（FVC）记录，在排除不可靠数据后，有 47 名患者保留用于当前研究。
使用来自 SCI 患者 FVC 的两天或三天的数据进行回顾性研究。计算夜间尿量（NUP）和夜间多尿指数（NPi）。
与白天和卧床休息（P=0.008）以及白天和睡眠（P=0.001）相比，尿量明显增加。所有患者在 12 小时夜间时间段（包括卧床休息和睡眠）期间均出现 NP，39 名患者在 8 小时睡眠时间段期间出现 NP。卧床休息和睡眠期间的平均尿量无显著差异。完全或不完全 SCI 患者以及 SCI 水平较高和较低的患者之间 NP 的患病率无显著差异。
本研究表明，SCI 患者 NP 的发生率很高，并且使用哪种 NP 定义进行诊断很重要。在卧床休息和睡眠期间观察到尿量增加，并且当在两个时间段使用夜间尿液产生定义时，诊断得到正确估计。与预期的情况一样，当使用 NP 指数类型定义时，NP 的诊断被高估了。
重要的是要意识到 SCI 患者中 NP 的频繁发生以及他们的日常活动对 NP 诊断准确性的影响。更多关于这个主题的知识可以帮助避免因夜间多尿引起的失禁。
