小儿遗尿症162例临床特点及治疗.docVIP

小儿遗尿症162例临床特点及治疗 　 作者：黄卫东，孙小妹，吴瑾，向承发 【摘要】 目的 分析儿童遗尿症的临床特点并对其治疗方法进行探讨。方法 对162例符合小儿遗尿症的患儿行尿常规及选择性地进行实验室和物理检查。明确病因者给予相应治疗，全部患儿行心理行为指导及排尿训练，43例加用盐酸丙米嗪（11例）或去氨加压素（32例）治疗。结果 162例中有家族遗传史的72例（44.4%），隐性脊柱裂（spina bifida occulta，SBO）39例，其他病因23例，无确切病因者28例。157例表现为原发性夜间遗尿症（primary nocturnal enuresis，PNE）。23例病因明确者19例治疗有效；其余139例中78例经单纯心理行为指导及排尿训练有效，31例加用药物治疗有效。结论 在遗尿症患儿诊治过程中，应作必要的检查，以排除器质性疾病；对PNE患儿的治疗中要注意心理行为问题的早期发现及干预；采用心理行为及药物的综合治疗可收到良好的效果。 【关键词】 遗尿症；儿童；病因；治疗 　　Clinical characteristic and treatment of enuresis in 162 children cases Abstract: Objective To observe the clinical characteristic and investigate the clinical treatment for enuresis. Methods The laboratory evaluations for 162 children diagnosed as enuresis included urinalysis and some other necessary laboratory evaluations. Children who were found definite pathogeny accepted corresponding clinical treatment. All children were given conduct instruction and micturition training, meanwhile, 11 cases were treated with chlorhydric acid imipramine and 32 cases with desmopressin. Results In 162 cases, there were 72 cases with familial inheritance, 39 cases with spina bifida occulta (SBO), 23 cases with other etiological factors and 28 cases were not found definite pathology. One hundred and fiftyseven cases were primary nocturnal enuresis (PNE). Among 23 cases with definite pathology accepted clinicial treatment, 19 cases were improved. The 78 cases of other 139 cases were also improved after conduct instruction and micturition training, 31 cases were improved by medicine plus additionally. Conclusion During diagnosis and treatment of enuresis, excluding organic disease by laboratory evaluations firstly was necessary. It is important to find behavioral problem and psychology intervene early. Conduct instruction and micturition training combined drug treatment is an effective treatment method. Keywords: enuresis; children; etiopathogenisis; treatment 遗尿症是儿科门诊经常遇到的问题，病程迁延反复，对患儿的生长发育和社会适应能力会造成不同程度的影响，给其家庭带来严重的烦恼［12］。本文对2000年1