Largo R H, Gianciaruso M, Prader A
Schweiz Med Wochenschr. 1978 Feb 4;108(5):155-60.
The development of bowel and bladder control from 0 to 18 years of age in 321 Swiss children of the Zurich Longitudinal Study (1955-1976) is described. 3% of the children had started toilet training by the age of 1 month and 96% by 12 months. Bowel control was completed in 32% at age one, in 75% at age two and in 97% at age three. Complete bladder control by day and at night was established in none of the children at age one, in 20% at ages two and three and in 90% at age five. About one quarter of the boys and one tenth of the girls had a period of incomplete bowel or bladder control between 6 and 18 years. During the prepubertal period, the annual incidence of enuresis was 7-15% in boys and 7-10% in girls, and that of encopresis 2-4% and 1-2% respectively. Some combination of enuresis diurna, enuresis nocturna and encopresis were found in 7% of all children, although in most children, these events did not occur simultaneously. With the exception of primary diurnal enuresis, the different types of enuresis and encopresis were more frequent in males than in females. By the onset of puberty, encopresis resolved in all children and enuresis persisted in only a few children. The role of toilet training and the etiologies and pathogenesis of enuresis and encopresis are discussed from a development point of view.
本文描述了苏黎世纵向研究（1955 - 1976年）中321名瑞士儿童从0到18岁肠道和膀胱控制能力的发展情况。3%的儿童在1个月大时就开始了如厕训练，12个月大时这一比例为96%。1岁时32%的儿童完成了肠道控制，2岁时为75%，3岁时为97%。1岁时没有儿童完全实现白天和夜间的膀胱控制，2岁和3岁时这一比例为20%，5岁时为90%。约四分之一的男孩和十分之一的女孩在6至18岁期间有过肠道或膀胱控制不完全的阶段。在青春期前，男孩尿床的年发病率为7 - 15%，女孩为7 - 10%，遗粪症的年发病率男孩为2 - 4%，女孩为1 - 2%。7%的儿童存在日间遗尿、夜间遗尿和遗粪症的某种组合，不过大多数儿童这些情况并非同时发生。除原发性日间遗尿外，不同类型的遗尿症和遗粪症在男性中比在女性中更常见。到青春期开始时，所有儿童的遗粪症都已解决，只有少数儿童仍存在遗尿症。本文从发育角度讨论了如厕训练的作用以及遗尿症和遗粪症的病因和发病机制。
