临床儿科杂志 ›› 2025, Vol. 43 ›› Issue (7): 483-499.doi: 10.12372/jcp.2025.25e0564
• 标准·方案·指南 • 下一篇
中国医师协会儿科医师分会肾脏疾病学组中国儿童遗尿疾病管理协作组
收稿日期:
2025-05-20
录用日期:
2025-06-10
出版日期:
2025-07-15
发布日期:
2025-06-27
Chinese Cooperative Group for the Management of Pediatric Enuresis Affiliated to Pediatric Nephrology Committee of Chinese Medical Doctor Association
Received:
2025-05-20
Accepted:
2025-06-10
Published:
2025-07-15
Online:
2025-06-27
摘要:
遗尿症是儿童期常见疾病,会对患儿的身心健康造成危害,规范化诊疗对遗尿症的疗效及改善预后非常重要。近年来,随着国内外临床研究证据的积累和新诊疗理念的临床应用,更新并完善遗尿症诊疗共识具有重要的临床意义。因此,中国医师协会儿科医师分会肾脏疾病学组中国儿童遗尿疾病管理协作组基于国内外最新循证依据,结合国内临床经验,对2014年版《中国儿童单症状性夜遗尿疾病管理专家共识》进行修订和更新。结合国际权威指南修订了遗尿症的定义,完善了遗尿症的诊断流程和标准化术语;更新了病史采集内容以强调鉴别其他疾病和共患病,修订了排尿日记的记录方式以提高依从性;对于单症状性遗尿症部分,增加了去氨加压素药物剂量调整及减停方案,完善了二线药物治疗的具体剂量推荐;新增了非单症状性遗尿症的治疗,包括治疗策略和药物治疗方案等。本共识按照临床问题为导向的方式提出了推荐意见,为遗尿症的管理提供了更全面的指导。
中图分类号:
中国医师协会儿科医师分会肾脏疾病学组中国儿童遗尿疾病管理协作组. 中国儿童遗尿症疾病管理专家共识(2025年)[J]. 临床儿科杂志, 2025, 43(7): 483-499.
Chinese Cooperative Group for the Management of Pediatric Enuresis Affiliated to Pediatric Nephrology Committee of Chinese Medical Doctor Association. Chinese expert consensus on management of nocturnal enuresis in children[J]. Journal of Clinical Pediatrics, 2025, 43(7): 483-499.
表1
遗尿疾病相关术语定义"
术 语 | 定义 |
---|---|
遗尿症(NE) | ≥5岁,平均每月至少1次夜间不自主排尿,并持续3个月及以上 |
MNE | 患儿仅有夜间遗尿,不伴有日间LUTS |
NMNE | 患儿不仅有夜间遗尿,还伴有日间LUTS |
PNE | 自幼遗尿,没有6个月以上的不尿床期,并除外器质性疾病 |
SNE | 之前已经有长达6个月或更长不尿床期后又再次出现尿床 |
预期膀胱容量(EBC) | <12岁时计算公式为:[(年龄+1)×30],单位mL;12~18岁为390 mL |
最大排尿量(MVV) | 24 h内出现的单次最大排尿量(早晨第1次排尿除外),该排尿量需在排尿日记中保持记录至少2天 |
夜间总尿量(TVV) | 包括入睡后夜间自主或不自主的排尿量(尿布增重或夜间起床排尿量)与清晨第1次尿量之和 |
夜间多尿(NP) | 夜间尿量超过同年龄段儿童预期膀胱容量130% |
膀胱过度活动症(OAB) | 一种以尿急症状为特征的症候群,可伴或不伴有急迫性尿失禁 |
日间LUTS | 日间发生漏尿、尿频、尿急、排尿次数减少、排尿困难、尿线中断或排尿中断 |
漏尿 | 多指白天不自觉将尿液排出体外 |
尿频 | 日间排尿≥8次·d-1 |
尿急 | 突然、意想不到和急迫的排尿 |
日间排尿次数减少 | 日间排尿<4次·d-1 |
排尿困难 | 排尿踌躇(排尿犹豫、启动困难)、尿流速缓慢,排尿费力、需按压以促进排尿 |
附表1
病史采集表"
病史 | 结果 |
---|---|
儿童是否夜间睡眠中尿床(提示严重度、治疗方法及预后) | □是 □否 |
1. 每周尿床的夜晚数: | 夜/周 |
2. 每晚尿床的次数: | 次 |
3. 每晚尿床时间(大致时间) | |
4. 尿意-觉醒功能:①排尿完毕后仍未醒,②排尿完毕后立即觉醒,③排尿超过一半觉醒,④排尿开始即觉醒,⑤有尿意即觉醒) | 选择: ①②③④⑤ |
5. 每晚遗尿量(可通过测量尿布增重进行计量) | g/ mL |
日间下尿路症状(以下症状提示膀胱功能障碍) | |
1. 日间发生的漏尿(提示膀胱活动过度/非单症状性遗尿) | □是 □否 |
内裤上的尿渍 | |
-排尿前 | □是 □否 |
-排尿后 | □是 □否 |
严重尿湿内裤(内裤非常湿) | □是 □否 |
漏尿频率(每日发生次数): | 次/天 |
每日间断或持续的漏尿 | □是 □否 |
3岁半以后的日间尿失禁病史 | □是 □否 |
2. 尿频(排尿次数每日≥8次) | □是 □否 |
3. 尿急,即突然和急迫的想要排尿(提示膀胱活动过度) | □是 □否 |
4. 日间排尿次数减少(<4次/日,提示排尿功能障碍) | □是 □否 |
5. 特殊憋尿姿势(如文森特氏屈膝礼-儿童突然停止活动,脚尖站立,双脚用力交叉或采取蹲位,脚后跟顶着会阴部) (提示排尿功能障碍) | □是 □否 |
6. 需按压以促进排尿 | □是 □否 |
7. 尿流中断,或一次接一次的数次排尿(提示排尿功能障碍) | □是 □否 |
8. 泌尿道感染病史(常与潜在的膀胱功能障碍相关) | □是 □否 |
9. 疾病和/或畸形 | |
泌尿道 | □是 □否 |
脊髓/神经系统 | □是 □否 |
合并症-可能预测治疗抵抗的因素 | |
1.存在以下排便症状或病史(可预测治疗抵抗:便秘治愈可能致遗尿症的治愈) | |
便秘(每周排便≤3次) | □是 □否 |
内裤上的大便痕迹(大便失禁) | □是 □否 |
2.存在心理/行为/精神问题,如注意缺陷多动障碍(ADHD)、孤独症谱系障碍(ASD)的证据(可预测治疗抵抗) | □是 □否 |
注意力不易集中、注意短暂 | □是 □否 |
活动过多 | □是 □否 |
情绪易冲动 | □是 □否 |
社会交往、交流障碍 | □是 □否 |
兴趣狭窄 | □是 □否 |
刻板重复的行为方式 | □是 □否 |
3.运动障碍和/或学习障碍和/或精神运动发育障碍的病史(可能提示中枢神经系统病变) | □是 □否 |
4.睡眠问题 | |
夜间睡眠时间 | |
早上起床时间 | |
是否有入睡困难,唤醒困难、多梦、白天嗜睡 | □是 □否 |
是否有严重打鼾和/或睡眠呼吸暂停 | □是 □否 |
饮水习惯 | |
1. 是否常喝饮料 | □是 □否 摄入量及类型: |
2. 晚间(睡前2~3小时内)是否饮水 | □是 □否 |
3. 晚间(睡前2~3小时内)饮水量超过200 mL | □是 □否 |
4. 晚餐是否饮用牛奶或晚餐进食粥、汤类食物 | □是 □否 |
5. 晚间是否食用有利尿作用或含水量多的水果(如西瓜等) | □是 □否 |
家族史和既往史 | |
1. 遗尿家族史(包括父母、同胞及其他亲属) | □是 □否 |
2. 既往泌尿系感染史 | □是 □否 |
3. 既往脊髓/泌尿系手术史 | □是 □否 |
4. 服用影响排尿的药物(如螺内酯、呋塞米等) | □是 □否 |
5. 既往遗尿的治疗方式 | 无治疗 有,治疗方式: |
[1] | 沈茜, 刘小梅, 姚勇, 等. 中国儿童单症状性夜遗尿疾病管理专家共识[J]. 临床儿科杂志, 2014, (10): 970-975. |
Shen Q, Liu XM, Yao Y, et al. Expert Consensus on the Management of Monosymptomatic Nocturnal Enuresis in Chinese Children[J]. Linchuang Erke Zazhi, 2014, (10): 970-975. | |
[2] | Wang TM, Yang SS, Tsai JD, et al. Management of nocturnal enuresis in Taiwan: Consensus statements of the Taiwan enuresis expert committee[J]. J Formos Med Assoc. 2019, 118(6):965-972. |
[3] | 中华医学会小儿外科学分会小儿尿动力和盆底学组和泌尿外科学组. 儿童遗尿症诊断和治疗中国专家共识[J]. 中华医学杂志, 2019, 99 (21): 1615-1620. |
The Pediatric Urodynamics and Pelvic Floor Group and the Urology Group of the Pediatric Surgery Branch of the Chinese Medical Association. Chinese Expert Consensus on Diagnosis and Treatment of Enuresis in Children[J]. Zhonghua Yixue Zazhi, 2019, 99 (21): 1615-1620. | |
[4] |
Austin PF, Bauer SB, Bower W, et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the standardization committee of the international children's continence society[J]. J Urol, 2014, 191(6): 1863-1865.
doi: 10.1016/j.juro.2014.01.110 pmid: 24508614 |
[5] | Austin PF, Bauer SB, Bower W, et al. The standardization of terminology of lower urinary tract function in children and adolescents: Update report from the standardization committee of the International Children's Continence Society[J]. Neurourol Urodyn, 2016, 35(4): 471-481. |
[6] | Nevéus T, Fonseca E, Franco I, et al. Management and treatment of nocturnal enuresis—an updated standardization document from the international children's continence society[J]. J Pediatr Urol, 2020, 16(1): 10-19. |
[7] | Bastos JM Netto, Rondon AV, Lima GRMD, et al. Brazilian consensus in enuresis- recomendations for clinical practice[J]. Int Braz J Urol, 2019, 45: 889-900. |
[8] | Bogaert G, Stein R, Undre S, et al. Practical recommen-dations of the eau‐espu guidelines committee for monosymptomatic enuresis—bedwetting[J]. Neurourol Urodyn, 2020, 39(2): 489-497. |
[9] | The Japanese Society of Nocturnal Enuresis. Nocturnal Enuresis Clinical Practice Guidelines[M]. Tokyo: Diagnosis and Treatment Press, 2021. |
[10] | Harris J, Lipson A, Dos Santos J. Evaluation and manage-ment of enuresis in the general paediatric setting[J]. Paediatr Child Health, 2023, 28(6): 362-376. |
[11] | 陶洋旭, 李建军. 医疗共识制订方法:德尔菲法和名义小组法[J]. 国际眼科纵览, 2021, 45(5): 369-373. |
Tao YX, Li JJ. Methods for developing medical consensus: Delphi method and nominal group technique[J]. Guoji Yanke Zonglan, 2021, 45(5): 369-373. | |
[12] | Karničnik K, Koren A, Kos N, et al. Prevalence and quality of life of slovenian children with primary nocturnal enuresis[J]. Int J Nephrol, 2012: 509012. |
[13] | Rangel RA, Seabra CR, Ferrarez CEPF, et al. Quality of life in enuretic children[J]. Int Braz J Urol, 2021, 47(3): 535-541. |
[14] | 中国医师协会儿科医师分会肾脏疾病学组中国儿童遗尿疾病管理协作组. 中国5-18岁人群遗尿症患病率的横断面调查[J]. 中国循证儿科杂志, 2020, 15(02): 81-86. |
Chinese Cooperative Group for the Management of Pediatric Enuresis Affiliated to Pediatric Nephrology Committee of Chinese Medical Doctor Association. Prevalence of nocturnal enuresis in children and adolescents aged 5 to 18 years in China[J]. Zhongguo Xunzheng Erke Zazhi, 2020, 15(2): 81-86. | |
[15] | Zhong S, Lin X, Wang M, et al. Periaqueductal gray subregions connectivity and its association with micturition desire-awakening function[J]. Eur Child Adolesc Psychiatry, 2025, 34(4): 1435-1444. |
[16] | Hyams JS, Di Lorenzo C, Saps M, et al. Childhood Functional Gastrointestinal Disorders: Child/Adolescent[J]. Gastroenterology, 2016, 15: S0016- 5085(16)00181-5. |
[17] | Vande Walle J, Rittig S, Tekgül S, et al. Enuresis: practical guidelines for primary care[J]. Br J Gen Pract, 2017, 67(660): 328-329. |
[18] |
Haid B, Tekgül S. Primary and secondary enuresis: pathophysiology, diagnosis, and treatment[J]. Eur Urol Focus, 2017, 3(2-3): 198-206.
doi: S2405-4569(17)30202-X pmid: 28888814 |
[19] |
Koff SA. Estimating bladder capacity in children[J]. Urology, 1983, 21(3): 248.
doi: 10.1016/0090-4295(83)90079-1 pmid: 6836800 |
[20] | Wang JJ, Wang DJ, Fu HD, et al. Evaluation of a new frequency-volume chart for children with primary monosymptomatic nocturnal enuresis: a prospective, comparative study[J]. World J Pediatr, 2021, 17(6): 643-652 |
[21] | Iscan B, Ozkayın N. Evaluation of health-related quality of life and affecting factors in child with enuresis[J]. J Pediatr Urol, 2020, 16(2): 195.e1-195.e7. |
[22] |
Hu HJ, Zhang ZW, Liang Y, et al. Prevalence, risk factors, and psychological effects of primary nocturnal enuresis in Chinese young adults[J]. Int Neurourol J, 2021, 25(1): 84-92.
doi: 10.5213/inj.2040398.149 pmid: 33819961 |
[23] | National Clinical Guideline Centre (UK). Nocturnal Enuresis: The Management of Bedwetting in Children and Young People[M]. London: Royal College of Physicians (UK); 2010. |
[24] |
Experience with the long-term use of desmopressin for nocturnal enuresis in children and adolescents[J]. BJU Int, 2002, 89(4): 420-425.
doi: 10.1046/j.1464-4096.2001.01546.x pmid: 11872036 |
[25] |
Purnomo AF, Daryanto B, Nurhadi P. Monosymptomatic nocturnal enuresis treatment using alarm-therapy and desmopressin: a meta-analysis approach[J]. Med Arch, 2021, 75(6): 431-435.
doi: 10.5455/medarh.2021.75.431-435 pmid: 35169370 |
[26] |
Kamperis K, Hagstroem S, Rittig S, et al. Combination of the enuresis alarm and desmopressin: second line treatment for nocturnal enuresis[J]. J Urol, 2008, 179(3): 1128-1131.
doi: 10.1016/j.juro.2007.10.088 pmid: 18206924 |
[27] | Tsuji S, Kaneko K. Management of treatment-resistant nocturnal enuresis[J]. Pediatr Int, 2023, 65(1): e15573. |
[28] | Liu J, Ni J, Miao Q, et al. Exploration of the optimal desmopressin treatment in children with monosymptomatic nocturnal enuresis: evidence from a Chinese cohort[J]. Front Pediatr. 2021, 8: 626083. |
[29] | 初梅, 曹力, 陈朝英, 等. 醋酸去氨加压素中长程疗法治疗儿童原发性单症状夜遗尿症疗效研究[J]. 中国实用儿科杂志, 2017, 32(11): 861-865. |
Chu M, Cao L, Chen ZY, et al. Efficacy of Long-term desmopressin acetate therapy for primary monosymptomatic nocturnal enuresis in children[J]. Zhongguo Shiyong Erke Zazhi, 2017, 32(11): 861-865. | |
[30] | Chua ME, Silangcruz JM, Chang SJ, et al. Desmopressin withdrawal strategy for pediatric enuresis: a meta-analysis[J]. Pediatrics, 2016, 138(1): e20160495. |
[31] |
Marschall-Kehrel D, Harms TW. Structured desmopressin withdrawal improves response and treatment outcome for monosymptomatic enuretic children[J]. J Urol, 2009, 182(4 Suppl): 2022-2026.
doi: 10.1016/j.juro.2009.03.068 pmid: 19695616 |
[32] |
Ohtomo Y, Umino D, Takada M, et al. Gradual tapering of desmopressin leads to better outcome in nocturnal enuresis[J]. Pediatr Int, 2015, 57(4): 656-658.
doi: 10.1111/ped.12614 pmid: 25728739 |
[33] | Kamperis K, Van Herzeele C, Rittig S, et al. Opti-mizing response to desmopressin in patients with monosymptomatic noc turnal enuresis[J]. Pediatr Nephrol, 2017, 32(2): 217-226. |
[34] |
Dalrymple RA, Wacogne ID. Gradual withdrawal of desmopressin in patients with enuresis leads to fewer relapses than an abrupt withdrawal[J]. Arch Dis Child Educ Pract Ed, 2017, 102: 335.
doi: 10.1136/archdischild-2017-313000 pmid: 28468819 |
[35] |
VandeWalle J, Stockner M, Raes A, et al. Desmopressin 30 years in clinical use: a safety review[J]. Curr Drug Saf, 2007, 2(3): 232-238.
pmid: 18690973 |
[36] |
Wolfish NM, Barkin J, Gorodzinsky F, et al. The Canadian enuresis study and evaluation--short- and long-term safety and efficacy of an oral desmopressin preparation[J]. Scand J Urol Nephrol, 2003, 37(1): 22-27
pmid: 12745738 |
[37] | Everaert K, Hervé F, Bosch R, et al. International continence society consensus on the diagnosis and treatment of nocturia[J]. Neurourol Urodyn, 2019, 38(2): 478-498. |
[38] |
Lucchini B, Simonetti GD, Ceschi A, et al. Severe signs of hyponatremia secondary to desmopressin treatment for enuresis: a systematic review[J]. J Pediatr Urol, 2013, 9 (6 Pt B): 1049-1053.
doi: 10.1016/j.jpurol.2013.02.012 pmid: 23619353 |
[39] |
Schulman SL, Stokes A, Salzman PM. The efficacy and safety of oral desmopressin in children with primary nocturnal enuresis[J]. J Urol, 2001, 166(6): 2427-2431.
pmid: 11696804 |
[40] | Watanabe T, Ikeda H, Ono T, et al. Comparison of wireless and wired alarm devices for nocturnal enuresis treatment[J]. Pediatr Int, 2022, 64(1): e15328. |
[41] |
Song P, Huang C, Wang Y, et al. Comparison of desmopressin, alarm, desmopressin plus alarm, and desmopressin plus anticholinergic agents in the management of paediatric monosymptomatic nocturnal enuresis: a network meta-analysis[J]. BJU Int, 2019, 123(3): 388-400.
doi: 10.1111/bju.14539 pmid: 30216627 |
[42] | Caldwell PH, Codarini M, Stewart F, et al. Alarm interventions for nocturnal enuresis in children [DB/J]. Cochrane Database Syst Rev, 2020, 5(5): CD002911. |
[43] |
Austin PF, Ferguson G, Yan Y, et al. Combination therapy with desmopressin and an anticholinergic medication for nonresponders to desmopressin for monosymptomatic nocturnal enuresis: a randomized, double-blind, placebo-controlled trial[J]. Pediatrics, 2008, 122(5): 1027-1032.
doi: 10.1542/peds.2007-3691 pmid: 18977983 |
[44] |
Hodges SJ, Atala A. A randomized, double-blind, placebo-controlled trial of anticholinergic medication for nonresponders to desmopressin for monosymptomatic nocturnal enuresis[J]. Curr Urol Rep, 2011, 12(1): 1-2.
doi: 10.1007/s11934-010-0150-4 pmid: 20972651 |
[45] | Yu J, Yan Z, Zhou S, et al. Desmopressin plus anti-cholinergic agent in the treatment of nocturnal enuresis: a meta-analysis[J]. Exp Ther Med, 2017, 14(4): 2875-2884. |
[46] | Cai T, Yao Y, Sun W, et al. Desmopressin in combination with anticholinergic agents in the treatment of nocturnal enuresis: a systematic review and meta-analysis[J]. Front Pediatr, 2023, 11: 1242777. |
[47] | Ghanavati PM, Khazaeli D, Amjadzadeh M. A comparison of the efficacy and tolerability of treating primary nocturnal enuresis with solifenacin plus desmopressin, tolterodine plus desmopressin, and desmopressin alone: a randomized controlled clinical trial[J]. Int Braz J Urol, 2021, 47(1): 73-81. |
[48] |
Park SJ, Park JM, Pai KS, et al. Desmopressin alone versus desmopressin and an anticholinergic in the first-line treatment of primary monosymptomatic nocturnal enuresis: a multicenter study[J]. Pediatr Nephrol, 2014, 29(7): 1195-1200.
doi: 10.1007/s00467-014-2751-5 pmid: 24477979 |
[49] | 徐虹, 丁洁, 易著文. 儿童肾脏病学[M]. 北京: 人民卫生出版社, 2018. |
Xu H, Ding J, Yi ZW. Pediatric Nephrology[M]. Beijing: People's Medical Publishing House. 2018. | |
[50] | Ramsay S, Lapointe É, Bolduc S. Comprehensive overview of the available pharmacotherapy for the treatment of non-neurogenic overactive bladder in children[J]. Expert Opin Pharmacother, 2022, 23(8): 991-1002. |
[51] | Van Arendonk KJ, Austin JC, Boyt MA, et al. Frequency of wetting is predictive of response to anticholinergic treatment in children with overactive bladder[J]. Urology, 2006, 67(5): 1049e54. |
[52] | Gish P, Mosholder AD, Truffa M, et al. Spectrum of central anticholinergic adverse effects associated with oxybutynin: comparison of pediatric and adult cases[J]. J Pediatr, 2009, 155(3): 432e4. |
[53] | Rakowska-Silska M, Jobs K, Paturej A, et al. Voiding disorders in pediatrician’s practice[J]. Clin Med Insights Pediatr, 2020, 14: 1179556520975035. |
[54] | Afshar K, Dos Santos J, Blais AS, et al. Canadian Urological Association guideline for the treatment of bladder dysfunction in children.[J] Can Urol Assoc J, 2021, 15(2): 13-18. |
[55] |
Krhut J, Skugarevská B, Míka D, et al. Clinical utility of β3-adrenoreceptor agonists for the treatment of overactive bladder: a review of the evidence and current recommendations[J]. Res Rep Urol, 2022, 14: 167-175.
doi: 10.2147/RRU.S309144 pmid: 35502186 |
[56] | Blais AS, Nadeau G, Moore K, et al. Prospective pilot study of mirabegron in pediatric patients with overactive bladder[J]. Eur Urol, 2016, 70(1): 9-13. |
[57] | Fujinaga S, Watanabe Y, Nakagawa M. Efficacy of the novel selective b3-adrenoreceptor agonist vibegron for treatment-resistant monosymptomatic nocturnal enuresis in children[J]. Int J Urol, 2020, 27(8): 693-694. |
[58] | Pillai RR, Sara B. Effectiveness of bladder retraining programme on bedwetting frequency and relapse rate of children with nocturnal enuresis[J]. J Pediatr Urol, 2024, 20(4): 602.e1-602.e12. |
[59] |
Garcia-Fernandez A, Petros PE. A four month squatting-based pelvic exercise regime cures day/night enuresis and bowel dysfunction in children aged 7-11 years[J]. Cent European J Urol, 2020, 73(3): 307-314.
doi: 10.5173/ceju.2020.0044 pmid: 33133658 |
[60] | Ebiloglu T, Ergin G, Irkilata HC, et al. The Biofeedback Treatment for Non-Monosymptomatic Enuresis Nocturna[J]. Neurourol Urodyn, 2016, 35(1): 58-61. |
[61] |
Lindström S, Fall M, Carlsson CA, et al. The neurophysiological basis of bladder inhibition in response to intravaginal electrical stimulation[J]. J Urol, 1983, 129: 405-410.
doi: 10.1016/s0022-5347(17)52127-8 pmid: 6834523 |
[62] |
Dutra MF, de Bessa J Júnior, et al. The effectiveness of parasacral transcutaneous electrical nerve stimulation in the treatment of monosymptomatic enuresis in children and adolescents: a systematic review[J]. Int Braz J Urol, 2024, 50(2): 136-151.
doi: 10.1590/S1677-5538.IBJU.2023.0618 pmid: 38386785 |
[63] | Mcgrath KH, Caldwell PH, Jones MP. The frequency of constipation in children with nocturnal enuresis: a comparison with parental reporting[J]. J Paediatr Child Health, 2008, 44(1-2): 19-27. |
[64] |
Hodges SJ, Anthony EY. Occult megarectum-a commonly unrecognized cause of enuresis[J]. Urology, 2012, 79(2): 421-424.
doi: 10.1016/j.urology.2011.10.015 pmid: 22173180 |
[65] |
Kim JH, Lee JH, Jung AY, Lee JW. The prevalence and therapeutic effect of constipation in pediatric overactive bladder[J]. Int Neurourol J, 2011, 15(4): 206-210.
doi: 10.5213/inj.2011.15.4.206 pmid: 22259734 |
[66] | Borch L, Hagstroem S, Bower WF, et al. Bladder and bowel dysfunction and the resolution of urinary incontinence with successful management of bowel symptoms in children[J]. Acta Paediatr, 2013, 102(5): e215-e220. |
[67] |
Dal Pra A, Cury FL, Souhami L. Radiation therapy and androgen deprivation in the management of high risk prostate cancer[J]. Int Braz J Urol, 2011, 37(2):161-175.
pmid: 21557833 |
[68] |
Baeyens D, Roeyers H, D'Haese L, et al. The prevalence of ADHD in children with enuresis: comparison between a tertiary and non-tertiary care sample[J]. Acta Paediatr. 2006, 95: 347-352.
doi: 10.1080/08035250500434736 pmid: 16497647 |
[69] | Ding H, Wang M, Hu K, et al. Adenotonsillectomy can decrease enuresis and sympathetic nervous activity in children with obstructive sleep apnea syndrome[J]. J Pediatr Urol, 2017, 13(1): 41.e1-41.e8. |
[70] | Tong C, He Q, Ho M, et al. Tuina for enuresis in children: a systematic review and meta-analysis of randomized controlled trials[J]. Front Public Health, 2022, 10: 821781. |
[71] |
Ton G, Lin C, Ho W, et al. The effects of laser acupuncture therapy on nocturnal enuresis: a systematic review and meta-analysis[J]. Med Acupunct, 2022, 34(4): 228-239.
doi: 10.1089/acu.2022.0002 pmid: 36046465 |
[72] | 王仲易, 杜可, 李晨, 等. 中医儿科临床诊疗指南·小儿遗尿症(修订)[J]. 中医儿科杂志, 2018, 14(1): 4-8. |
Wang ZY, Du K, Li C, et al. Clinical practice guidelines for pediatrics in traditional chinese medicine - enuresis in children (revised)[J]. Zhongyi Erke Zazhi, 2018, 14(1): 4-8. | |
[73] |
Sharifiaghdas F, Narouie B, Ahmadzade M, et al. Urodynamic findings in children with primary refractory nocturnal enuresis: 10 years' experience of a tertiary center[J]. Health Sci Rep, 2023, 6(10): e1626.
doi: 10.1002/hsr2.1626 pmid: 37829504 |
[1] | 王颖硕, 陈志敏. 数智化赋能儿童支气管哮喘的诊治和管理[J]. 临床儿科杂志, 2025, 43(7): 500-504. |
[2] | 赵琳朝, 王英洁, 景沼贺, 买钰淼, 孙盼, 邱思敏, 牛宏运, 陈志伟, 董芃芃, 刘健. 造血干细胞移植治疗儿童遗传性骨髓衰竭综合征疗效及预后分析[J]. 临床儿科杂志, 2025, 43(7): 505-510. |
[3] | 张志奇, 熊若兰, 李泊涵, 吉奇, 王庆伟, 卢俊, 李捷, 肖佩芳, 胡绍燕. 儿童白血病脐带血移植原发性植入失败预测模型的构建[J]. 临床儿科杂志, 2025, 43(7): 511-518. |
[4] | 姜雯雯, 李思彤, 徐勇胜. 儿童肺结核γ-干扰素释放试验假阴性结果影响因素分析[J]. 临床儿科杂志, 2025, 43(7): 519-524. |
[5] | 李凡, 黄先杰, 范亚珍, 赵建闯, 崔晨航, 郭芪良, 乔俊英. 托珠单抗治疗儿童热性感染相关性癫痫综合征2例并文献复习[J]. 临床儿科杂志, 2025, 43(7): 532-538. |
[6] | 段浩林, 张慈柳, 熊娟, 庞楠, 尹飞, 彭镜. SMN1基因复合杂合变异脊髓性肌萎缩症患者疾病修正治疗的临床疗效分析[J]. 临床儿科杂志, 2025, 43(7): 543-548. |
[7] | 何爽, 许欣, 周雪, 刘茜, 张蕾, 田杰, 吕铁伟. 经颈内静脉植入无导线心脏起搏器:1例15 kg先天性心脏病术后三度房室传导阻滞患儿临床实践与思考[J]. 临床儿科杂志, 2025, 43(7): 549-553. |
[8] | 李奋. 推动无导线心脏起搏器在儿科领域的研究与应用[J]. 临床儿科杂志, 2025, 43(7): 554-555. |
[9] | 吕明君, 罗文, 杨锦向, 梁键莹, 姚志荣. 儿童泛发性脓疱型银屑病发病机制及治疗进展[J]. 临床儿科杂志, 2025, 43(7): 556-562. |
[10] | 张宏文. 依库珠单抗在儿童系统性红斑狼疮治疗中的应用及思考[J]. 临床儿科杂志, 2025, 43(6): 403-407. |
[11] | 李秋宇, 刘飞, 赵曼丽, 顾伟忠, 冯春月, 傅海东. 3 496例儿童肾脏疾病病理资料分析:一项单中心回顾性研究[J]. 临床儿科杂志, 2025, 43(6): 411-417. |
[12] | 王瑞雪, 王润杰, 李小露, 张婷, 肖咏梅. 乳果糖氢甲烷呼气试验阳性患儿临床特征及内镜和病理表现分析[J]. 临床儿科杂志, 2025, 43(6): 418-425. |
[13] | 岳阳, 张志华, 李玫, 刘志峰, 郭红梅. 英夫利昔单抗诱导治疗儿童克罗恩病疗效的预测指标分析[J]. 临床儿科杂志, 2025, 43(6): 426-431. |
[14] | 谢利林, 许锦平, 姚拥华. 儿童动脉缺血性脑卒中临床特征分析:一项单中心回顾性研究[J]. 临床儿科杂志, 2025, 43(6): 432-437. |
[15] | 杜婷婷, 姚辉, 陈晓红, 杨禄红, 丰利芳, 陈晓倩, 胡曼, 李亚坤. 儿童鞍区肿瘤术后垂体功能减退与代谢相关脂肪性肝病关系的研究[J]. 临床儿科杂志, 2025, 43(6): 438-444. |
|