Abstract: Objective To learn about the clinical features and the related influencing factors of nocturnal enuresis(NE) children with different arousal levels at night, so as to provide reference for individualized treatment. Method The clinical manifestations of 100 patients diagnosed with primary monosymptomatic nocturnal enuresis were investigated from June to September 2017 and descriptive statistical analysis was performed. Results There were 58 male cases and 42 females,and the age ranged from 5 to 16 years old,with an average age of (7.78±2.76) years old.The number of children with enuresis ≤3 times /week,4 to 7 times/week,8 to 14 times/week,and ＞14 times/week were 24(24%),49(49%),14(14%) and 13(13%),respectively.Most of nocturnal enuresis(36%) occurred at 11:00 PM to 12 PM,followed by 10:00 PM to 11:00 PM.The numbers of children waking up after a little bedwetting,bedwetting a lot and finish urination were 9(9%),9(9%) and 12(12%),respectively.Single factor analysis showed that hyperactivity,grinding teeth,and the teacher's criticism were related to the failure to wake up after enuresis(P＜0.05).Multivariate Logistic regression analysis showed that hyperactivity was an independent risk factor for the failure to wake up after enuresis(OR=2.798,95%CI:1.034-7.572.). Conclusion When formulating the individualized diagnosis and treatment plan for children with enuresis,it is necessary to comprehensively consider the neuropsychological development and social environmental factors.

Key words: arousal level, nocturia, neuropsychological development, social environmental factors, children

摘要： 目的 了解不同唤醒水平夜间遗尿症儿童的临床特征及相关影响因素,为个体化治疗提供依据。方法 对 2017年6-9月在上海儿童医学中心确诊为原发性单一症状性夜间遗尿症的100例患儿临床表现进行问卷调查,并进行描述性统计分析。结果 100例患儿中男58 例,女 42 例;年龄 5～16 岁,平均年龄(7.78±2.76) 岁;患儿遗尿频率≤3次/周24人(24%),4～7次/周49人(49%),8～14次/周14人(14%),＞14次/周13人(13%);夜间首次遗尿发生时间在晚间11:00-12:00时段的人数最多(占总人数的 36 %),其次为晚间10:00-11:00;遗尿后尿出一点即醒9人(9%)、尿出较多即醒9人(9%)、尿完后再醒的12人(12%),尿完后仍不醒人数为70人,占总例数的70%;单因素分析显示,多动、磨牙、被老师批评与遗尿后不能醒来有关(P<0.05);多因素Logistic回归分析显示,多动是儿童遗尿后不能唤醒的独立危险因素(OR=2.798,95%CI:1.034~7.572)。结论 制定遗尿儿童的个性化诊疗方案时,需综合考虑其神经心理发育及社会环境因素。

关键词: 唤醒水平, 遗尿症, 神经心理发育, 社会环境因素, 儿童