探索难治性与反应性儿童遗尿症的临床和尿液因素：一项比较研究。
Exploring clinical and urinary factors in treatment-resistant vs. treatment-responsive childhood enuresis: a comparative study.
作者信息
Lorestani Parsa, Khodadadiyan Alireza, Kaviari Mohammad Amin, Montazeri Alireza, Golmoradi Hadi, Lorestani Amir Mohammad, Tohidi Mohamad Reza
机构信息
Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
出版信息
BMC Pediatr. 2025 Apr 23;25(1):321. doi: 10.1186/s12887-025-05669-7.
BACKGROUND
Nocturnal enuresis represents a persistent pediatric health challenge characterized by variable treatment responses. Despite established therapeutic interventions, a substantial proportion of children fail to achieve successful management, highlighting the critical need for a deeper understanding of treatment resistance mechanisms. This study sought to systematically examine the multifaceted factors underlying differential treatment outcomes in childhood enuresis.
METHODS
A cross-sectional analytical study was conducted in 2017 at Mohammad Kermanshahi Hospital, Iran. The study included 144 children aged 5-8 years with nocturnal enuresis, divided into treatment-controlled (n = 85) and treatment-resistant (n = 59) groups. Participants received Desmopressin nasal spray (DDAVP) at 10 mcg/spray nightly. Demographics, clinical characteristics, sleep patterns, urination habits, and ultrasound findings were analyzed.
RESULTS
The prevalence of controlled nocturnal enuresis was higher than treatment-resistant cases. Factors, including abnormal residual urine volume (P-value = 0.04), one episode of bedwetting per night (P-value = 0.03) and more than one episode of bedwetting per night (P-value = 0.02) were found to be statistically significant in our findings. Factors more common in the treatment-responsive group included deep sleep (85.9%), daytime urinary control (77.6%). Conversely, treatment-resistant children exhibited higher rates of poor medication adherence (94.9%), high urine volume per episode (86.4%), although these parameters were identified as non-statistically significant in our study.
CONCLUSION
This study highlights critical factors differentiating treatment-resistant from treatment-responsive nocturnal enuresis in children. Key factors such as deep sleep, daytime urinary control, and effective fluid management were associated with controlled enuresis, while treatment-resistant cases were marked by poor adherence to medication, high urine volume per episode, and frequent enuresis. Future research should explore long-term efficacy and innovative approaches to enhance the management of nocturnal enuresis.
CLINICAL TRIAL NUMBER
Not applicable (This was a cross-sectional analytical study and did not involve a clinical trial).
背景
夜间遗尿是一项持续存在的儿童健康挑战，其治疗反应具有多样性。尽管已有既定的治疗干预措施，但仍有相当比例的儿童未能成功治愈，这凸显了深入了解治疗抵抗机制的迫切需求。本研究旨在系统地探究儿童遗尿症不同治疗结果背后的多方面因素。
方法
2017年在伊朗的穆罕默德·克尔曼沙希医院开展了一项横断面分析研究。该研究纳入了144名年龄在5至8岁的夜间遗尿儿童，分为治疗有效组（n = 85）和治疗抵抗组（n = 59）。参与者每晚使用10微克/喷的去氨加压素鼻喷雾剂（DDAVP）。对人口统计学、临床特征、睡眠模式、排尿习惯和超声检查结果进行了分析。
结果
治疗有效的夜间遗尿患病率高于治疗抵抗病例。在我们的研究结果中，发现异常残余尿量（P值 = 0.04）、每晚尿床一次（P值 = 0.03）和每晚尿床不止一次（P值 = 0.02）等因素具有统计学意义。治疗反应良好组中更常见的因素包括深度睡眠（85.9%）、白天控尿（77.6%）。相反，治疗抵抗的儿童表现出更高的药物依从性差率（94.9%）、每次尿量多（86.4%），尽管这些参数在我们的研究中未被确定为具有统计学意义。
结论
本研究突出了区分儿童治疗抵抗性与治疗反应性夜间遗尿的关键因素。深度睡眠、白天控尿和有效的液体管理等关键因素与遗尿得到控制有关，而治疗抵抗病例的特点是药物依从性差、每次尿量多和频繁遗尿。未来的研究应探索长期疗效和创新方法，以加强对夜间遗尿的管理。
临床试验编号
不适用（这是一项横断面分析研究，未涉及临床试验）
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