Epidemiological investigation and analysis of primary nocturnal enuresis and PNE-induced mental disorders among children aged 5-7 yearsin Huangzhou District, Huanggang City
GUO Jun, KONG Yuan-rong, WANG Jin-ye, YANG Hui, CHEN Ke
Department of Pediatrics, Maternal and Child Health Hospital of Huanggang City, Huanggang, Hubei 438000, China
Abstract:Objective To explore the epidemiology of primary nocturnal enuresis (PNE) and PNE-induced mental disorders in children aged 5-7 years in Huangzhou District, Huanggang City, and to provide references for clinical prevention and treatment of PNE and PNE-induced mental disorders in children. Methods A stratified cluster sampling method was used to select 2,580 children aged 5-7 years in 13 kindergartens in Huangzhou District, Huanggang City from March 2014 and December 2015. A questionnaire survey on the incidence of PEN and PEN-induced mental disorders was conducted. Results After excluding the invalid questionnaires, a total of 2,418 children were enrolled into this study, and 511 (21.13%) had PEN. The incidence rate of PEN decreased with the increase of age, and the differences in the incidence rates of PEN among different age groups showed statistically significant (P<0.05). The common symptom in the 511 children with PEN was nocturnal enuresis (accounting for 68.10%). As for the frequency of nocturnal enuresis, 4-7 times per week was the highest (accounting for 36.40%). Most (74.95%) of the children were difficult to wake up at night, and children who never got up to urinate at night accounted for 67.32%. And no statistically significant differences were found among different age groups (P>0.05). 265 (51.86%) PEN children had various degrees of mental disorders. Emotional instability and impulsive emotion were the most common symptoms (61.13%), followed by low self-esteem and psychological tension (49.43%), and social anxiety (48.68%). The incidence rate of mental disorders increased with the increase of age, and the differences among different age groups showed statistically significant (P<0.05). Conclusions The incidence rate of PNE in children aged 5-7 years is relatively higher, but it decreases with the increase of age. The incidence rates of urination at night, nocturnal enuresis 4 to 7 times per week, waking up at night difficultly and never getting up to urinate at night are relatively higher. Most of the PNE children may be complicated by mental disorders, and the incidence rate increases with age. Clinicians and parents can prevent the occurrence of PEN and PEN-induced mental disorders from medication, psychological and behavioral interventions.
[1] 彭振居,范美丽,王广新,等.儿童遗尿症与隐性脊柱裂的关系及其临床意义[J].中国妇幼保健,2012,27(18):2774-2775. [2] 彭振居,范美丽,伊长英,等.小儿遗尿症668例临床分析[J].湖南师范大学学报(医学版),2013,10(1):42-44. [3] Hashem M, Morteza A, Mohammad K, et al. Prevalence of nocturnal enuresis in school aged children: the role of personal and parents related socio-economic and educational factors[J]. Iran J Pediatr, 2013, 23(1):59-64. [4] Nrgaard JP, vanGool JDvan, Hjlms K, et al. Standardization and definitions in lower urinary tract dysfunction in children. International Children's Continence Society[J]. Br J Urol, 1998, 81(1):1-16. [5] Ramírez-Backhaus M, Martínez AE, Arlandis GS, et al.Prevalence of nocturnal enuresis in the Valencian Community. Pediatric section of the National Incontinence Survey. The EPICC Study[J]. Actas Urol Esp, 2009, 33(9):1011-1018. [6] 沈颖,刘小梅.儿童遗尿症的诊治进展[J].北京医学,2013,35(1):33-35. [7] 吕麟亚,李旭良,何大维,等.小儿原发性遗尿症治疗方法选择及疗效评价[J].中华小儿外科杂志, 2003, 24(4):326-328. [8] 班彩霞,陈伟平,贝为武,等.南宁市5~6岁儿童遗尿症的流行病学调查[J].广西医学,2015,37(6):840-841. [9] 王爱华,廖鸣慧,刘小梅,等.遗尿症儿童情绪状态及其影响因素分析[J].中华实用儿科临床杂志,2016,31(2):136-139. [10] 周蔚然,刘小梅,沈颖,等.儿童原发性遗尿症发病机制的研究进展[J].中华实用儿科临床杂志,2013,28(23):1828-1830. [11] Joinson C, Heron J, Emond A, et al. Psychological problems in children with bedwetting and combined (day and night) wetting: a UK population-based study[J]. J Pediatr Psychol, 2007, 32(5):605-616. [12] 邓会英,高岩,叶红,等.干床训练和弥凝治疗儿童原发性遗尿症的临床观察[J].实用医学杂志,2008,24(11):1928-1930. [13] 潘晓芬,雷辛衍,林国模,等.6~11岁原发性遗尿症儿童心理行为问题及相关因素研究[J].中国儿童保健杂志,2016,24(5):525-528. [14] 庄艳云,邱惠仙,叶丽芹,等.家庭护理干预对小儿原发性遗尿症的疗效观察[J].医学临床研究,2013,30(6):1242-1243.