遗尿（尿床）Enuresis (bedwetting)

尿失禁或遗尿（尿床）pUR宋宝林医生

什么是尿失禁（遗尿）？pUR宋宝林医生

尿失禁（遗尿）是尿床的医学术语。尿失禁是指在本来能够控制自己膀胱的年龄的孩子，有意外或故意的排尿。女生通常早于男孩获得膀胱控制。年龄超过5岁的女孩和超过6岁的男孩，仍然有排尿控制问题，就可能诊断尿失禁。有不同类型的尿床可能发生，包括以下内容：pUR宋宝林医生

•白天遗尿。白天湿裤子。pUR宋宝林医生

•夜间遗尿。夜间湿裤子。pUR宋宝林医生

•原发性遗尿。这发生在当孩子从来没有完全掌握如厕训练时。pUR宋宝林医生

•继发性遗尿。这发生当孩子确实有一个时期不湿裤子，但随后又回到失禁期。pUR宋宝林医生

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预防和风险评估pUR宋宝林医生

关于尿失禁有哪些关键性事实吗？

根据美国儿科学会：pUR宋宝林医生

•尿床会影响到20％的5岁儿童，10％的6岁儿童，以及3％的12岁儿童。pUR宋宝林医生

•夜间遗尿发生在男孩的机会比女孩多两倍。pUR宋宝林医生

•遗尿的儿童中，大部分在夜晚尿湿裤子。pUR宋宝林医生

•原发性遗尿是儿童尿失禁最常见的形式。pUR宋宝林医生

是什么原因引起尿失禁？

可能涉及许多因素，也有许多理论来解释为什么儿童尿湿裤子。以下是这个问题可能原因的列表：pUR宋宝林医生

•如厕训练差pUR宋宝林医生

•保存尿的能力延迟。 （这可能是一个直到约五岁的因素。）pUR宋宝林医生

•小膀胱pUR宋宝林医生

•睡眠习惯差或存在睡眠障碍pUR宋宝林医生

•有助于调节排尿的荷尔蒙正常运作出现了问题pUR宋宝林医生

•大多数尿床的孩子至少有一个父母或近亲，在儿童时期也曾遭受过尿床pUR宋宝林医生

•影响睡眠的药物pUR宋宝林医生

诊断pUR宋宝林医生

如何诊断尿失禁？

尿失禁（遗尿）的诊断通常是基于完整的病史和你孩子的体检。除了与你和孩子谈话，你孩子的医生可能进行以下检查来帮助排除其他原因引起的尿湿裤：pUR宋宝林医生

•验尿（以确保没有潜在的感染或疾病，如糖尿病）pUR宋宝林医生

•测量血压pUR宋宝林医生

•验血pUR宋宝林医生

治疗pUR宋宝林医生

尿失禁（遗尿）有什么治疗？

你孩子的医生将根据以下情况来确定遗尿的具体治疗：pUR宋宝林医生

•您孩子的年龄，整体健康状况和病史pUR宋宝林医生

•病症的程度pUR宋宝林医生

•您的孩子对特定的药物、手术或治疗的耐受力pUR宋宝林医生

•对这种状况过程的预期pUR宋宝林医生

•您的意见或偏好pUR宋宝林医生

开始治疗前，重要须知：pUR宋宝林医生

•孩子是完全没有责任的，绝不应该受到惩罚。孩子是无法控制尿湿裤子的。pUR宋宝林医生

•根据美国糖尿病、消化道和肾脏疾病研究所的研究，受影响的孩子到5岁以后，遗尿每年的自然消失率大约为15％。pUR宋宝林医生

治疗可包括：pUR宋宝林医生

•儿童的积极强化（比如使用贴纸图表来记录没有湿裤子的夜晚）pUR宋宝林医生

•使用夜间报警，有助于当尿湿时告诉孩子pUR宋宝林医生

•药物，由您孩子的医生开出（以帮助控制尿湿）pUR宋宝林医生

•膀胱训练，以帮助提高膀胱容量，也提高孩子对何时他们必须去排尿的认知能力（这项是这样来完成的，在白天让孩子等待尽可能长的时间去排尿，并让膀胱得到充盈）pUR宋宝林医生

•晚上减少饮水（如果孩子认为它有帮助的话，美国儿科学会建议这个方法），避免咖啡因pUR宋宝林医生

此外，孩子及其家庭的咨询可能有助于确定孩子可能有的一些压力。pUR宋宝林医生

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Urinary Incontinence or Enuresis (bedwetting)pUR宋宝林医生

What is urinary incontinence (enuresis)?pUR宋宝林医生

Urinary incontinence (enuresis) is the medical term for bedwetting. Incontinence is accidental or intentional urination in children who are at an age where they should be able to have control of their bladders. Girls usually obtain bladder control before boys. Incontinence may be diagnosed in girls older than age 5 and in boys who are older than age 6 who are still having urinary control problems. There are different types of bedwetting that may occur, including the following:pUR宋宝林医生

·Diurnal enuresis.Wetting during the day.pUR宋宝林医生

·Nocturnal enuresis. Wetting during the night.pUR宋宝林医生

·Primary enuresis. This occurs when the child has never fully mastered toilet training.pUR宋宝林医生

·Secondary enuresis.This occurs when the child did have a period of dryness, but then returned to having periods of incontinence.pUR宋宝林医生

Prevention & Risk AssessmentpUR宋宝林医生

What are some key facts about urinary incontinence?

According to the American Academy of Pediatrics: pUR宋宝林医生

·Bedwetting affects 20 percent of 5-year-olds, 10 percent of 6-year-olds, and 3 percent of 12-year-olds.pUR宋宝林医生

·Nocturnal enuresis occurs two times more frequently in boys than in girls.pUR宋宝林医生

·Of the children with enuresis, most have wetting at night. pUR宋宝林医生

·Primary enuresis is the most common form of urinary incontinence among children.pUR宋宝林医生

What causes urinary incontinence?

There are many factors that may be involved, and many theories that are given for why children wet. The following is a list of some of the possible reasons for the problem:pUR宋宝林医生

·Poor toilet trainingpUR宋宝林医生

·Delay of the ability to hold urine. (This may be a factor up to about the age of five.)pUR宋宝林医生

·Small bladderspUR宋宝林医生

·Poor sleep habits or the presence of a sleep disorderpUR宋宝林医生

·A problem with the proper functioning of hormones that help to regulate urinationpUR宋宝林医生

·Most children who wet the bed have at least one parent or a close relative who also suffered from bedwetting as a child pUR宋宝林医生

·Medication that affects sleeppUR宋宝林医生

DiagnosispUR宋宝林医生

How is urinary incontinence diagnosed?

Urinary incontinence (enuresis) is usually diagnosed based on a complete medical history and physical examination of your child. In addition to talking with you and the child, your child's doctor may perform the following to help rule out other causes for the wetting:pUR宋宝林医生

·Urine tests (to make sure there is not an underlying infection, or condition, such as diabetes)pUR宋宝林医生

·Blood pressure measurementpUR宋宝林医生

·Blood testspUR宋宝林医生

TreatmentspUR宋宝林医生

What is the treatment for urinary incontinence (enuresis)?

Specific treatment for enuresis will be determined by your child's doctor based on:pUR宋宝林医生

·Your child's age, overall health, and medical historypUR宋宝林医生

·Extent of the conditionpUR宋宝林医生

·Your child's tolerance for specific medications, procedures, or therapiespUR宋宝林医生

·Expectations for the course of the conditionpUR宋宝林医生

·Your opinion or preferencepUR宋宝林医生

Prior to starting treatment, it is important to know that:pUR宋宝林医生

·The child is not at fault and should not be punished. The child cannot control the wetting.pUR宋宝林医生

·According to the National Institute of Diabetes and Digestive and Kidney Diseases, after age 5 enuresis disappears naturally at a rate of about 15 percent of affected children each year.pUR宋宝林医生

Treatment may include:pUR宋宝林医生

·Positive reinforcement of the child (such as the use of sticker charts for dry nights)pUR宋宝林医生

·Use of night-time alarms to help tell the child when wetting is occurringpUR宋宝林医生

·Medications, as prescribed by your child's doctor (to help control the wetting)pUR宋宝林医生

·Bladder training to help increase the bladder size and the child's ability to know when they have to urinate (this is done by having the child wait as long as possible during the day to urinate and let the bladder get full)pUR宋宝林医生

·Decrease fluids (AAP suggests this approach if the child believes it helps) and avoid caffeine at nightpUR宋宝林医生

In addition, counseling of the child and family may help to determine any stress the child may be under.pUR宋宝林医生