摘要目的 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.

abstractsObjective 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.