上海市浦东新区5~18岁儿童与青少年夜遗尿症流行病学调查

汪张娟; 沈小钰; 殷蕾; 沙莎; 周纬; 赵醴; 龚丽霞

doi:10.16766/j.cnki.issn.1674-4152.003088

上海市浦东新区5~18岁儿童与青少年夜遗尿症流行病学调查

doi: 10.16766/j.cnki.issn.1674-4152.003088

汪张娟¹,
沈小钰^{1, 2, ,},
殷蕾²,
沙莎^{2, 3},
周纬²,
赵醴¹,
龚丽霞¹

1.
上海交通大学医学院附属上海儿童医学中心国际诊疗部，上海 200127
2.
上海交通大学医学院附属上海儿童医学中心肾脏内科
3.
上海交通大学医学院附属上海儿童医学中心新生儿科

基金项目:

上海市综合医院中西医结合专项 ZHYY-ZXYJHZX-202027

详细信息

通讯作者:
沈小钰，E-mail：shenxiaoyu@scmc.com.cn

中图分类号: R256.54 R181.2 R179
计量
- 文章访问数: 92
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- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2022-09-26
- 网络出版日期: 2023-08-28

Epidemiological investigation and correlation analysis of enuresis in children and adolescents aged 5-18 years in Pudong New District of Shanghai

WANG Zhangjuan¹,
SHEN Xiaoyu^{1, 2
, ,},
YIN Lei²,
SHA Sha^{2, 3},
ZHOU Wei²,
ZHAO Li¹,
GONG Lixia¹

1.
International Medical Department, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China

摘要

摘要: 目的对上海市浦东新区5~18周岁儿童与青少年夜遗尿症进行流行病学调查及分析，探讨儿童夜遗尿症患病情况及其相关因素，为临床防治提供依据。方法采用横断面调查研究方法，于2017年4月20日—2017年5月12日对上海市浦东新区12所学校5~18周岁儿童与青少年家长进行问卷调查，并根据遗尿严重程度分为遗尿组和3个月内有过遗尿现象组，比较2组相关因素的差异。结果共发放2 711份问卷，收集2 627份问卷，问卷回收率为96.90%，本次研究发现在5~18周岁儿童与青少年中遗尿症患病率为1.26%(33/2 627)，男性患病率为1.77%(24/1 358)，女性患病率为0.71%(9/1 269)，男性患病率高于女性(P=0.015)，部分遗尿症伴随着年龄增长会逐渐改善；33.3%(11/33)的遗尿症儿童及青少年中有家族史，25.7%(29/113)3个月内发生过遗尿现象的孩子有家族史，遗尿症与遗传有明显的相关性。遗尿对儿童及家庭成员的情绪和生活质量有影响，并随着遗尿严重程度而不同，差异有统计学意义(P < 0.05)。家长因遗尿而责备或打骂儿童的发生率较高。遗尿儿童普遍存在睡前多饮。结论医护应注重对遗尿患儿和家长的情绪疏导，从心理指导和行为治疗等多方面进行防治。
- 遗尿症 /
- 流行病学调查 /
- 儿童 /
- 青少年
Abstract: Objective To investigate the prevalence and related factors of nocturnal enuresis in children and adolescents aged 5-18 years in Pudong New Area of Shanghai, and to provide evidence for clinical prevention and treatment. Methods Using a cross-sectional survey research method, a questionnaire survey was conducted among the parents of children and adolescents aged 5-18 years in 12 schools in Pudong New Area by random cluster sampling. According to the severity of enuresis, the children were divided into two groups: the enuresis group and the group who had bed wetting within 3 months. Results A total of 2 711 questionnaires were distributed and 2 627 cases of enuresis were collected, the questionnaire response rate was 96.90%. In this study, the prevalence of enuresis in children and adolescents aged 5-18 was 1.26% (33/2 627), 1.77% (24/1 358) in males, and 0.71% (9/1 269) in females. The prevalence of enuresis in males was higher than that in females (P=0.015). Enuresis improves gradually with age; 33.3% (11/33) of the children and adolescents with enuresis had a family history, 25.7% (29/113) of the children with bed wetting within 3 months had a family history, and enuresis was obviously correlated with inheritance. Enuresis affected the mood and quality of life of children and family members, and the difference was statistically significant with the severity of enuresis (P < 0.05). The incidence of parents blaming and abusing children for enuresis was high. Excessive bedtime drinking was common in children with enuresis. Conclusion Clinicians should pay attention to the emotion disclosure of children with enuresis and their parents. Prevention and treatment should be carried out from many aspects, such as psychological guidance and behavioral therapy.
- Nocturnal Enuresis /
- Epidemiological investigation /
- Child /
- Adolescent

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表 1 遗尿儿童家系分析(例数/总例数)

Table 1. Pedigree Analysis of children with enuresis (cases/total cases)

组别	例数	家族史阳性	常染色体显性	常染色体隐性	其他遗传方式	一级亲属遗传	二级亲属遗传
遗尿症组	33	11/33	8/11	2/11	1/11	10/11	1/11
3个月内有遗尿现象组	113	29/113	21/29	5/29	3/29	26/29	3/29
χ²值				0.017		0.014
P值				0.992		0.700

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表 2 遗尿对儿童和家长情绪、睡眠、生活的影响

Table 2. Effects of enuresis on mood, sleep, and life of children and parents

种类	组别	级别					Z值	P值
种类	组别	1	2	3	4	5	Z值	P值
对家长的烦恼	遗尿组	8	7	5	3	10	-3.639	< 0.001
	3个月内有遗尿现象组	61	23	14	6	9
对儿童的烦恼	遗尿组	10	7	9	0	7	-2.978	0.003
	3个月内有遗尿现象组	66	21	11	4	11
对儿童睡眠影响	遗尿组	8	10	6	0	9	-3.263	0.001
	3个月内有遗尿现象组	62	24	12	6	9
对家长睡眠影响	遗尿组	8	3	10	1	11	-3.769	< 0.001
	3个月内有遗尿现象组	53	29	18	6	7
对儿童生活影响	遗尿组	12	8	8	0	5	-2.079	0.038
	3个月内有遗尿现象组	63	26	9	5	10

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表 3 遗尿儿童各类事件比较(例)

Table 3. Comparison of various events in children with enuresis (cases)

组别	例数	存在诱发因素	责备或打骂孩子	睡前饮水	就医
遗尿症组	33	5	14	25	13
3个月内有遗尿现象组	113	28	41	85	15
χ²值		1.353	0.410	0.004	11.242
P值		0.245	0.522	0.950	0.001

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参考文献(19)

[1]	HAID B, TEKGÜL S. Primary and secondary enuresis: pathophysiology, diagnosis, and treatment[J]. Eur Urol Focus, 2017, 3(2-3): 198-206. doi: 10.1016/j.euf.2017.08.010
[2]	沈小钰, 郭竹英, 金莹莹, 等. 基于小儿遗尿症临床症候群选用缩泉胶囊和醒脾养儿颗粒的疗效观察[J]. 中华全科医学, 2019, 17(2): 173-175, 204. doi: 10.16766/j.cnki.issn.1674-4152.000631 SHEN X Y, GUO Z Y, JIN Y Y, et al. Clinical observation of Suoquan capsule and Xingpi Yanger granule treatment on infantile enuresis based on the clinical syndromes[J]. Chinese Journal of General Practice, 2019, 17(2);173-175, 204. doi: 10.16766/j.cnki.issn.1674-4152.000631
[3]	中国医师协会儿科医师分会肾脏疾病学组中国儿童遗尿疾病管理协作组. 中国5~18岁人群遗尿症患病率的横断面调查[J]. 中国循证儿科杂志, 2020, 15(2): 81-86. https://www.cnki.com.cn/Article/CJFDTOTAL-XZEK202002001.htm Chinese Cooperative Group for the Management of Pediatric Enuresis Affiliated to Pediatric Nephrology Committee of Chinese Medical Doctor Association. Prevalence of nocturnal enuresis in children and adolescents aged 5 to 18 years in China[J]. Chinese Journal of Evidence Based Pediatrics, 2020, 15(2): 81-86. https://www.cnki.com.cn/Article/CJFDTOTAL-XZEK202002001.htm
[4]	HAMED A, YOUSF F, HUSSEIN M M. Prevalence of nocturnal enuresis and related risk factors in school-age children in Egypt: an epidemiological study[J]. World J Urol, 2017, 35(3): 459-465. doi: 10.1007/s00345-016-1879-2
[5]	宋奇翔, 李佳怡, 王磊, 等. 成年男性和女性夜间遗尿症患者的临床特点分析[J]. 中华泌尿外科杂志, 2021, 42(6): 462-467. doi: 10.3760/cma.j.cn112330-20210519-00276 LI Q X, LI J Y, WANG L, et al. The clinical features of nocturnal enuresis in adult men and women[J]. Chinese Journal of Urology, 2021, 42(6): 462-467. doi: 10.3760/cma.j.cn112330-20210519-00276
[6]	文建军, 胡绘杰, 罗艳艳, 等. 大学生家族性原发性遗尿症现状调查[J]. 郑州大学学报(医学版), 2022, 57(2): 258-261. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYK202202022.htm WEN J J, HU H J, LUO Y Y, et al. Survey of familial primary nocturnal enuresis in university students[J]. Journal of Zhengzhou University(Medical Sciences), 2022, 57(2): 258-261. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYK202202022.htm
[7]	韩中将, 文一博, 汪玺正, 等. 儿童原发性遗尿症不同亚型患病率调查[J]. 中华小儿外科杂志, 2019, 40(12): 1118-1119, 1122. doi: 10.3760/cma.j.issn.0253-3006.2019.12.011 HAN Z J, WEN Y B, WANG X Z, et al. A survey on the prevalence of different subtypes of primary enuresis in children[J]. Chinese Journal of Pediatric Surgery, 2019, 40(12): 1118-1119, 1122. doi: 10.3760/cma.j.issn.0253-3006.2019.12.011
[8]	范典标, 孙节, 吴跃进, 等. 上海市金山区5~13岁儿童遗尿症流行病学调查[J]. 公共卫生与预防医学, 2020, 31(1): 113-117. https://www.cnki.com.cn/Article/CJFDTOTAL-FBYF202001026.htm FAN D B, SUN J, WU Y J, et al. Epidemiological investigation of enuresis in children aged 5-13 years old in Jinshan District of Shanghai[J]. Journal of Public Health and Rreventive Medicine, 2020, 31(1): 113-117. https://www.cnki.com.cn/Article/CJFDTOTAL-FBYF202001026.htm
[9]	姚勇. 儿童夜尿症发病机制与干预策略[J]. 中国实用儿科杂志, 2017, 32(2): 153-158. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSEK201702021.htm YAO Y. Pathogenesis and intervention strategy of nocturia in children[J]. Chinese Journal of Practical Pediatrics, 2017, 32(2): 153-158. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSEK201702021.htm
[10]	JØRGENSEN C S, HORSDAL H T, RAJAGOPAL V M, et al. Identification of genetic loci associated with nocturnal enuresis: a genome-wide association study[J]. Lancet Child Adolesc Health, 2021, 5(3): 201-209.
[11]	马蕾, 张丽芝. 云南省玉溪市红塔区5~16岁儿童遗尿症发病相关因素调查[J]. 昆明医科大学学报, 2019, 40(4): 71-75. https://www.cnki.com.cn/Article/CJFDTOTAL-KMYX201904015.htm MA L, ZHANG L Z. Investigation and Analysis of the Factors of Nocturnal Enuresis in 5-16-year-old Children in Hongta District, Yuxi City, Yunnan Province[J]. Journal of Kunming Medical University, 2019, 40(4): 71-75. https://www.cnki.com.cn/Article/CJFDTOTAL-KMYX201904015.htm
[12]	赵谷娜, 张思敏, 贾甜, 等. 责任制整体护理联合家庭系统心理护理在儿童遗尿症护理中的应用效果分析[J]. 国际精神病学杂志, 2018, 45(5): 951-954. https://www.cnki.com.cn/Article/CJFDTOTAL-GWYJ201805057.htm ZHAO G N, ZHANG S M, JIA T, et al. Effect of responsibility system holistic nursing combination with family system psychological nursing on children with enuresis[J]. Journal of International Psychiatry, 2018, 45(5): 951-954. https://www.cnki.com.cn/Article/CJFDTOTAL-GWYJ201805057.htm
[13]	李东燕. 浙江省儿童和青少年夜遗尿情况调查分析[J]. 浙江临床医学, 2021, 23(7): 1009-1010, 1014. LI D Y. Investigation and analysis of nocturnal enuresis among children and adolescents in Zhejiang province[J]. Zhejiang Clinical Medical Journal, 2021, 23(7): 1009-1010, 1014.
[14]	TAI T T, TAI B T, CHANG Y J, et al. The importance of understanding parental perception when treating primary nocturnal enuresis: a topic review and an institutional experience[J]. Res Rep Urol, 2021, 13: 679-690.
[15]	HAMED S A, FAWZY M, HAMED E A. Behavioral problems in children with primary monosymptomatic nocturnal enuresis[J]. Compr Psychiatry, 2021, 104: 152208. DOI: 10.1016/j.comppsych.2020.152208.
[16]	郭骏, 孔院容, 王金叶, 等. 黄冈市黄州区5~7岁儿童原发性遗尿症及其致心理障碍的流行病学调查分析[J]. 实用预防医学, 2017, 24(5): 590-593. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYY201705023.htm GUO J, KONG Y R, WANG J Y, et al. Epidemiological investigation and analysis of primary nocturnal enuresis and PNE-induced mental disorders among children aged 5-7 years in Huangzhou District, Huanggang City[J]. Practical Preventive Medecine, 2017, 24(5): 590-593. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYY201705023.htm
[17]	NEVÉUS T, FONSECA E, FRANCO I, et al. Management and treatment of nocturnal enuresis-an updated standardization document from the International Children's Continence Society[J]. J Pediatr Urol, 2020, 16(1): 10-19.
[18]	WALKER R A. Nocturnal Enuresis[J]. Prim Care, 2019, 46(2): 243-248.
[19]	文建国. 遗尿症的发病机制及诊断和治疗新进展[J]. 郑州大学学报(医学版), 2017, 52(6): 661-667. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYK201706001.htm WEN J G. The pathogenesis, diagnosis and treatment of enuresis[J]. Journal of Zhengzhou University(Medical Sciences), 2017, 52(6): 661-667. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYK201706001.htm