CAJ | 학술논문

目的回顾分析尿动力学检测儿童特异性日间尿频(extraordinary daytime urinary frequency,EDUF)患儿膀胱功能变化,评价膀胱功能训练的疗效.方法本组共204例.其中,男126例,女78例;年龄3～14岁,中位年龄6.7岁;病程2周～12年.临床症状为日间尿频,入睡后症状消失.无尿路感染、尿路解剖或神经病学异常.根据国际小儿尿控协会(International Children's Continence Society,ICCS)规定的标准及定义,采用Laborie尿动力学检测仪评价最大膀胱测量容量(cystometry bladder capacity,CBC)及逼尿肌活动功能.在膀胱压力容积测定后,进行膀胱储尿功能训练.训练后1周随访排尿频率及排尿量,评价疗效.疗效好转者,可接受第2次训练,1周后再次评价疗效.结果 EDUF在3～7岁发生率最高,为69.12％(141/204),随着生长发育,发生率逐渐下降.57例(27.94％％)有明确的社会心理压力诱因.膀胱功能改变者113例(55.39％),男性69例(54.76％),女性44例(56.41％).其中,CBC下降71例(34.8％),逼尿肌不稳定(DI) 69例(33.82％).204例均接受膀胱储尿功能训练,经过第1次训练后1周随访,146例(71.57％)治愈,37例(17.14％)好转,21例(10.29％)无效.疗效与CBC降低关系分析发现,CBC降低的训练效果较差.接受第1次膀胱功能训练后症状好转的23例患儿接受了第2次训练,19例(82.61％)获得治愈.本组总治愈率为80.88％(165/204),无尿储留或尿路感染等并发症产生.结论尿动力学在检测EDUF的膀胱功能变化同时,可进行膀胱训练治疗,效果良好,是治疗EDUF的有效措施之一.
목적 회고분석뇨동역학검측인동특이성일간뇨빈(extraordinary daytime urinary frequency,EDUF)환인방광공능변화,평개방광공능훈련적료효.방법 본조공204례.기중,남126례,녀78례;년령3～14세,중위년령6.7세;병정2주～12년.림상증상위일간뇨빈,입수후증상소실.무뇨로감염、뇨로해부혹신경병학이상.근거국제소인뇨공협회(International Children's Continence Society,ICCS)규정적표준급정의,채용Laborie뇨동역학검측의평개최대방광측량용량(cystometry bladder capacity,CBC)급핍뇨기활동공능.재방광압력용적측정후,진행방광저뇨공능훈련.훈련후1주수방배뇨빈솔급배뇨량,평개료효.료효호전자,가접수제2차훈련,1주후재차평개료효.결과 EDUF재3～7세발생솔최고,위69.12％(141/204),수착생장발육,발생솔축점하강.57례(27.94％％)유명학적사회심리압력유인.방광공능개변자113례(55.39％),남성69례(54.76％),녀성44례(56.41％).기중,CBC하강71례(34.8％),핍뇨기불은정(DI) 69례(33.82％).204례균접수방광저뇨공능훈련,경과제1차훈련후1주수방,146례(71.57％)치유,37례(17.14％)호전,21례(10.29％)무효.료효여CBC강저관계분석발현,CBC강저적훈련효과교차.접수제1차방광공능훈련후증상호전적23례환인접수료제2차훈련,19례(82.61％)획득치유.본조총치유솔위80.88％(165/204),무뇨저류혹뇨로감염등병발증산생.결론 뇨동역학재검측EDUF적방광공능변화동시,가진행방광훈련치료,효과량호,시치료EDUF적유효조시지일.
Objective To retrospectively analyze the bladder function of to extraordinary daytime urinary frequency (EDUF) in children by urodynamic system and to evaluate the efficacy of bladder training.Methods A total of 204 children (126 boys,78 girls,aged 3-14 years) with a diagnosis of EDUF were recruited.The duration of symptoms was from 2 weeks to 12 years.The major symptom was frequent daytime voiding disappearing during sleeps.There was no history of urinary tract infection,urological anatomic or neurological abnormality.According to the criteria of International Children's Continence Society (ICCS),CBC (cystometry bladder capacity) and detrusor function were elevated respectively by urodynamic system.Bladder training was conducted after cystometric study.One week later,voiding frequency and urinary volume were followed up.For those with improved symptoms,one more session of training was provided.Results The 3-7 years old patients had the highest incidence of EDUF at 69.12％ (141/204).With increasing age,the incidence declined.And 57 cases (27.94％) had possible psychosocial problems or recent emotional stressors.Bladder dysfunction was found in 113 cases (55.39％) including 69 boys (54.76％) and 44 girls (56.41％).CBC decreased in 71 cases (34.8％) and detrusor instability was found in 69 cases (33.82％).One week after training,146 cases (71.57％) were cured,37 (17.14％) improved and 21 (10.29％) were ineffective.Efficacy and decreasing CBC relationship analysis revealed that the training outcome was worse in children with decreasing CBC.And 23 patients with improved symptom received the second training and 19 cases (82.61 ％) were finally cured.The total cure rate of training was 80.88％ without any complication,such as urinary retention or infection.Conclusions Cystometry urodynamic may evaluate bladder function and offer bladder training simultaneously.And it is efficacious in the treatment of EDUF in childhood.