存在治疗抵抗因素的单症状性夜遗尿儿童临床表现及治疗效果分析  

Clinical symptoms and treatment outcomes of children with monosymptomatic nocturnal enuresis having treatment-resistant factors

作　　者：李博雅 李娇[1] 杨博[1] 唐耘熳[1] 毛宇 覃道锐 陈绍基 王学军[1] Li Boya;Li Jiao;Yang Bo;Tang Yunman;Mao Yu;Qin Daorui;Chen Shaoji;Wang Xuejun(Department of Pediatric Surgery,Sichuan Provincial People's Hospital,Affiliated Hospital of Electronic Science&Technology University,Chengdu 610072,China)

机构地区：[1]电子科技大学附属医院,四川省人民医院小儿外科,成都610072

出　　处：《临床小儿外科杂志》2023年第2期105-111,共7页Journal of Clinical Pediatric Surgery

基　　金：国家自然科学基金资助项目(82101666)

摘　　要：目的对比存在治疗抵抗因素[隐性脊柱裂、儿童注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)、遗尿家族史、便秘、腺样体/扁桃体肥大]的单症状性夜遗尿患儿与无治疗抵抗因素的遗尿患儿在临床表现及治疗效果之间的差异。方法回顾性分析2021年1月至2022年1月四川省人民医院小儿外科遗尿门诊就诊的510例单症状性夜遗尿患儿临床资料,包括基线情况、治疗抵抗因素相关测评指标、遗尿频次评估指标以及治疗周期和治疗结局。依据数据类型使用t检验、χ^(2)检验及非参数检验进行统计学分析。结果510例患儿中,无治疗抵抗因素434例,为对照组;存在治疗抵抗因素76例,为抵抗组,包括合并隐性脊柱裂21例、ADHD 18例、遗尿家族史15例、便秘14例、腺样体/扁桃体肥大8例。两组患儿年龄及性别差异无统计学意义(P>0.05),抵抗组就诊时夜间遗尿频率显著高于对照组(P<0.001),且常需使用多种治疗手段(P<0.001)。治疗效果方面,抵抗组需更长治疗时间(P<0.001),且治愈率显著低于对照组(P<0.001),仅隐性脊柱裂患儿治疗结局与对照组差异无统计学意义(P>0.05)。结论存在治疗抵抗因素的单症状性夜遗尿患儿症状重,治疗周期长,治愈率低。Objective To compare the symptoms and treatment outcomes of children with monosymptomatic nocturnal enuresis(MSNE)having treatment-resistant factors[occult spina bifida,attention deficit hyperactivity disorder(ADHD),family history of enuresis,constipation&adenoid/tonsil hypertrophy]with those without treatment-resistant factors.Methods From January 2021 to January 2022,clinical data of MSNE children were retrospectively reviewed,including baseline profiles,symptoms related to treatment-resistance factors,frequency of enuresis,treatment course and treatment outcomes.The relevant clinical data were analyzed by t,χ^(2)and nonparametric tests according to data type.Results A total of 434 children without treatment-resistant factors(control group)and 76 children with treatment-resistant factors(resistant group)were included,concurrently occult spina bifida(n=21),ADHD(n=18),family history of enuresis(n=15),constipation(n=14)and adenoid/tonsillar hypertrophy(n=8).No significant inter-group difference existed in age or gender.The frequency of nocturnal enuresis was significantly higher in resistant group than that in control group(P<0.001)and multiple treatments were often required(P<0.001).In terms of treatment outcomes,resistant group often required longer treatment course(P<0.001)and cure rate was significantly lower than that in control group(P<0.001).Overall performance and treatment outcome of specific resistant factors(occult spina bifida,ADHD,family history of enuresis,constipation&adenoid/tonsil hypertrophy)were similar.Except for treatment outcome of occult spina bifida group,it failed to show a distinct statistical difference from control group.Conclusion Children with MSNE with treatment-resistant factors are significantly more symptomatic.With a longer treatment course,it has a lower cure rate.

关 键 词：夜间遗尿症 病因学 夜间遗尿症 病理生理学 治疗结果 儿童 

分 类 号：R726.9[医药卫生—儿科]