Suman Sanjay, Robinson Dudley, Bhal Nadia, Fraser Susannah, MacCormick Angus, Williams Ann, Tadtayev Sergey
Clinical Co-Director, Therapies and Older Persons Programme, Medway NHS Foundation Trust, Gillingham, Kent.
Consultant Urogynaecologist and Honorary Senior Lecturer, Department of Urogynaecology, King's College Hospital, London.
Br J Hosp Med (Lond). 2019 Sep 2;80(9):517-524. doi: 10.12968/hmed.2019.80.9.517.
Nocturia may be a multifactorial condition and should be regarded as a syndrome rather than a diagnosis, with many factors contributing to the clinical presentation. The effects of sleep deprivation can have a severely detrimental impact on the quality of life and productivity of the working age population, with considerable economic implications. Patients are unlikely to seek an appointment with their GP complaining of nocturia - they are more likely to complain of the effects of the condition, such as chronic tiredness, or injuries resulting from falls. The main criterion in deciding whether a patient should undergo further investigations into suspected nocturia is the degree to which the patient finds the condition bothersome. In some patients, lifestyle modifications may be an effective way to manage nocturia before medication is considered. As the only licensed product for all adults including those over 65 years of age, low dose desmopressin (Noqdirna (as lyophilisate) Ferring Pharmaceuticals Ltd) is highly effective in the management of idiopathic nocturnal polyuria, producing improvements in clinical symptoms, sleep parameters and quality of life. Care should be administered as a joint enterprise between the patient's GP and colleagues in secondary care. This article outlines the findings of a roundtable discussion into the optimal management of patients with nocturnal polyuria.
夜尿症可能是一种多因素导致的病症，应被视为一种综合征而非诊断结果，有许多因素会导致其临床表现。睡眠剥夺对工作年龄人群的生活质量和生产力会产生严重的不利影响，还会带来可观的经济影响。患者不太可能因夜尿症而就诊——他们更可能抱怨该病症的影响，比如慢性疲劳或跌倒造成的损伤。决定患者是否应就疑似夜尿症接受进一步检查的主要标准是患者觉得该病症困扰的程度。对一些患者而言，在考虑用药之前，改变生活方式可能是管理夜尿症的有效方法。作为唯一适用于所有成年人（包括65岁以上人群）的获批产品，低剂量去氨加压素（诺迪纳（冻干品），辉凌制药有限公司）在治疗特发性夜间多尿症方面非常有效，能改善临床症状、睡眠参数和生活质量。治疗应由患者的全科医生和二级医疗同事共同进行。本文概述了关于夜间多尿症患者最佳管理的圆桌讨论结果。
