排尿日记对醋酸去氨加压素和遗尿报警器治疗原发性单症状夜遗尿症疗效的预测作用  

Voiding diary predicts the therapeutic effects on primary monosymptomatic nocturnal enuresis

作　　者：李帅[1] 杨帅 周钊凯 张艳平 杨静[1] 张国贤[2] 王庆伟[1,2] 陆伟 文建国[1,2] LI Shuai;YANG Shuai;ZHOU Zhaokai;ZHANG Yanping;YANG Jing;ZHANG Guoxian;WANG Qingwei;LU Wei;WEN Jianguo(Henan Joint International Pediatric Urodynamic Laboratory of the First Affiliated Hospital of Zhengzhou University,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052;Department of Urology,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052;Department of Urology,Xinyang Central Hospital,Xinyang Hospital Affiliated to Zhengzhou University,Xinyang 464099,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泌尿外科,河南郑州450052 [3]郑州大学附属信阳医院信阳市中心医院泌尿外科,河南信阳464099

出　　处：《现代泌尿外科杂志》2023年第4期283-286,291,共5页Journal of Modern Urology

基　　金：国家自然科学基金项目(No.U1904208)。

摘　　要：目的评估排尿日记(VD)预测醋酸去氨加压素(DDAVP)或遗尿报警器(EA)治疗原发性单症状夜遗尿(PMNE)效果。方法2018年1月—2022年10月对100例门诊诊断为PMNE的6~14岁患儿进行前瞻性随访分析。以两周VD划分膀胱类型。使用丹麦的REDCap系统对患者进行伪随机化处理分组,分为随机选取治疗方案组(随机组)与根据VD选取治疗方案组(VD组),治疗周期为8周。结果共82名患儿符合统计要求。VD组有效率为82.50%(33/40),随机组有效率为59.52%(25/42),两者的治疗效果存在显著性差异(χ^(2)=5.224,P=0.022)。在随机组中,不考虑患儿VD的前提下,随机DDAVP组与随机EA组治疗有效率分别为81.82%(18/22)和25.00%(5/20),两种治疗方案存在显著性差异(χ^(2)=13.625,P=0.000)。结论VD可以预测PMNE的治疗效果,患者选定治疗方案前有必要记录两周VD。不依靠VD选择治疗方案的患者,DDAVP的治疗效果优于EA,但是停药后的复发率需要进一步随访。Objective To investigate the possibility of using voiding diary(VD)to predict desmopressin diacetate arginine vasopressin(DDAVP)and enuresis alarm(EA)in the treatment of primary monosymptomatic nocturnal enuresis(PMNE).Methods A total of 100 children(aged 6 to 14 years)with PMNE treated during Jan.2018 and Oct.2022 were involved.Bladder type was classified with two-week VD.Pseudo-randomization was performed using the Danish REDCap system to group patients into the randomized group and VD group.All patients were treated for 8 weeks.Results A total of 82 cases met the inclusive criteria.The effective rate was 82.50%(33/40)and 59.52%(25/42)in the VD and randomized groups,respectively,with significant difference(χ^(2)=5.224,P=0.022).In the randomized group,if VD was not considered,the effective rate in the DDAVP and EA subgroups was 81.82%(18/22)and 25.00%(5/20),respectively,with significant difference(χ^(2)=13.625,P=0.000).Conclusion VD can predict the therapeutic effects of PMNE.It is necessary to record VD for two weeks before selecting appropriate treatment methods.For patients who choose treatment without reference to VD,DDAVP shows better response than EA,but the recurrence rate after discontinuation of treatment requires further follow-up.

关 键 词：儿童 遗尿 去氨加压素 遗尿报警器 治疗 

分 类 号：R726.9[医药卫生—儿科]