儿童原发性遗尿症阶梯治疗的远期疗效

目的比较阶梯治疗和单纯药物治疗对儿童原发性遗尿症的远期疗效。方法将确诊为原发性遗尿症的102例患儿随机分为阶梯治疗组(A组,n=48,采用阶梯性治疗方法)和单纯药物治疗组(B组,n=54,采用单纯口服弥凝治疗方法)。治疗前和治疗结束3个月后分别记录1个月夜间遗尿频率,治疗前和治疗结束时进行最大憋尿状态下膀胱容量B超检测及日间、夜间尿比重测定。结果A组远期治愈率(65%)显著高于B组(39%)(P<0.05);治疗后A组膀胱容量与体质量的比值显著大于B组(P<0.01);治疗后A组夜尿比重与日尿比重的差值显著大于B组(P<0.01)。结论阶梯治疗对原发性遗尿症较传统单纯药物治疗远期治愈率显著提高,且利于疗效的生理功能变化更为显著,是一种快捷、可靠的遗尿症治疗新方法。

Long-term curative effects of step-by-step treatment for primary enuresis in children

Objective To compare the long-term curative effects in children with primary nocturnal enuresis(PNE) between step-by-step treatment and desmopressin treatment. Methods One hundred and two children with PNE were randomized into step-by-step treatment group(group A,n=48) and desmopressin treatment group(group B,n=54).The frequencies of bed-wetting during 1 month were recorded before treatment and 3 months after treatment completion.Bladder capacities were tested by means of B-ultrasound when their bladders were extremely full.Day-time and night-time uric specific gravities were also measured. Results The long-term cure rate was significantly higher in group A(65%)than in group B(39%)(P<0.05).After treatment the ratio of bladder capacity to body weight was significantly higher in group A than in group B(P<0.01),and the difference between day-time and night-time uric specific gravity was much bigger in group A than in group B(P<0.01). Conclusion The step-by-step treatment for PNE exerts better long-term curative effects than desmopressin treatment.The step-by-step treatment makes obvious changes in children's physiological structures and functions which facilitate constant better curative effects.It is a novel,quick and reliable treatment for PNE.