尿流动力学在儿童及青少年遗尿中的应用价值

目的:探讨和分析尿流动力学检查在儿童及青少年遗尿症中的临床价值.方法:对我院诊治的61例遗尿症儿童及青少年进行尿流动力学检查,根据检查结果,并结合其临床症状、体征及其它辅助检查,选择适当的个体化治疗方案.结果:其中有42例尿流动力学检查结果显示异常,占总例数的68.9％; 19例尿流动力学检查结果显示无异常发现,占总例数的31.1％.结论:膀胱敏感性增加、膀胱容量相对减小、膀胱逼尿肌无抑制性不稳定收缩、膀胱顺应性和尿道压减低、出现残余尿量是遗尿症儿童及青少年尿流动力学检查结果出现异常的常见原因,行尿动力学检查在一定程度上能为遗尿症儿童及青少年在诊疗方案的选择上提供临床指导和参考.     

Pathogenesis and brain functional imaging in nocturnal enuresis: A review

Nocturnal enuresis is a common and distressing developmental disease, which may cause various degrees of psychosocial stress and impairment to self-esteem in affected children as well as agitation to their parents or caregivers. Nevertheless, the etiology and pathogenesis of nocturnal enuresis are not understood. Currently, nocturnal enuresis is generally considered a multifactorial disease associated with a complex interaction of somatic, psychosocial, and environmental factors. A variety of postulations have been proposed to explain the occurrence and progression of nocturnal enuresis, including hereditary aberration, abnormal circadian rhythm of antidiuretic hormone secretion during sleep, bladder dysfunction, abnormal sleep, difficulties in arousal, neuropsychological disorders, and maturational delays of the brain. In recent decades, the introduction of functional neuroimaging technologies has provided new approaches for uncovering the mechanisms underlying nocturnal enuresis. The main neuroimaging modalities have included brain morphometry based on structural magnetic resonance imaging (MRI), task-based and event-related functional MRI (fMRI), and resting-state fMRI. The relevant studies have indicated that nocturnal enuresis is associated with functional and structural alterations of the brain. In this review, we briefly summarized the popular hypotheses regarding the pathogenesis of nocturnal enuresis and the current progress of functional neuroimaging studies in examining the underlying mechanisms thereof.