幼儿尿不湿依赖86例临床特征和治疗效果分析  

Effects of toilet training on 86 young children with disposable diaper dependence

作　　者：李一冬[1] 王一鹤 杨静[2] 吕磊 李琦[1,3] 胡绘杰 李守林 孙雪蕊 文建国 LI Yidong;WANG Yihe;YANG Jing;L Lei;LI Qi;HU Huijie;LI Shoulin;SUN Xuerui;WEN Jianguo(Henan Joint International Pediatric Urodynamic Laboratory,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052;Reception of First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052;Department of Urology,Children s Hospital of Chongqing Medical University,Chongqing 400014;Department of Nursing,First Affiliated Hospital of Zhengzhou University,Xinxiang 453100;Department of Urology,Shenzhen Children s Hospital,Shenzhen 518035,China)

机构地区：[1]郑州大学第一附属医院河南省小儿尿动力国际联合实验室,河南郑州450052 [2]郑州大学第一附属医院接诊处,河南郑州450052 [3]重庆医科大学儿童医院泌尿外科,重庆400014 [4]新乡医学院护理学院,河南新乡453100 [5]深圳儿童医院泌尿外科,深圳518035

出　　处：《现代泌尿外科杂志》2021年第8期651-654,共4页Journal of Modern Urology

基　　金：国家自然科学基金(No.U1904208);河南省科技厅国际合作重点项目(No.182102410002);深圳市医疗卫生三名工程项目(No.SZSM201612013)。

摘　　要：目的了解幼儿尿不湿(DD)依赖的临床特征和治疗效果。方法本研究收集2019年6月至2020年10月在郑州大学第一附属医院和深圳儿童医院门诊就诊的日间DD依赖(DDD)幼儿86例(2~5岁)进行前瞻性随机分组治疗效果随访分析。幼儿分为治疗组和观察组,治疗组采用以如厕(排尿、排便)训练(TT)为主的治疗措施;观察组继续使用DD观察自然转归,分别在治疗3、6个月时随访治疗效果。治愈标准为日间能完全自主控制大小便。结果DDD幼儿随机分为治疗组(36例)和观察组(50例)。幼儿中有小便不能控制的30例,大便不能控制26例,大小便均无法控制的16例,14例伴有便秘情况。治疗后随访显示治疗组治愈率明显高于观察组,治疗组和观察组3个月时的治愈率为55.56%(20/36)vs.2.00%(1/50),P<0.05,6个月时为72.22%(26/36)vs.20.00%(10/50),P<0.05。治疗组剩余10例幼儿6个月时随访时9例均显示部分治愈,观察组剩余40例幼儿15例显示部分治愈,差异有统计学意义。结论TT是治疗DDD相关的大小便不能控制的有效方法。2岁以前开始TT有利于预防DDD的发生。Objective To investigate the clinical characteristics and therapeutic effects of toilet training(TT)on dispo-sable diaper dependence(DDD)in young children.Methods A total of 86 young children with DDD aged 2 to 5 years were randomized into DDD treatment group(n=36)and DDD observation group(n=50).The treatment group received TT,while the observation group continued to use DD to observe.The therapeutic effects were checked 3 months and 6 months after treatment.Complete response was defined as full control of defecation and/or urination during the daytime,and partial response referred to 50% to 99% reduction of incontinence.Results Of all children,30 had urinary incontinence,26 had fecal incontinence,16 had both fecal and urinary incontinence,14 had constipation.After treatment,there were significant differences in complete and partial response between treatment and observation groups complete response:55.56%(20/36)vs.2.00%(1/50)at 3 months,72.22%(26/36)vs.20.00%(10/50)at 6 months.Of the remaining 10 cases in the treatment group,9 showed partial cure after 6-month follow-up,while of the remaining 40 cases in the observation group,15 showed partial cure,with statistically significant difference.Conclusion TT is effective for the treatment of uncontrollable defecation and urination associated with DDD.The study supports initiating TT before the age of 2 in young children.

关 键 词：尿不湿 依赖 如厕训练 幼儿 诊断 治疗 

分 类 号：R454[医药卫生—治疗学]