台灣夜間遺尿（尿床）的共識與治療建議

The Consensus and Treatment Guideline of Enuresis in Taiwan

楊緒棣(Stephen Shei-Dei Yang) ； 邱益煊(Yee-Hsuan Chiou) ； 林清淵(Ching-Yuang Lin) ； 車參薇(Tsang-Wee Cher) ； 余燦榮(Tsan-Jung Yu) ； 林登龍(Alex T. L. Lin) ； 陳世乾(Shyh-Chyan Chen) ； 賴明坤(Ming-Kuen Lai)

《中華民國泌尿科醫學會雜誌》 11卷3期 (2000/09) Pp. 97-104

https://doi.org/10.7024/JUAROC.200009.0097

摘要

本文報告台灣尿床研究會關於夜間遺尿（尿床）的共識與治療建議。本建議依據國內外已發表的報告，及本研究會醫師臨床經驗綜合而成。台灣的尿床盛行率和多數西方國家相似。長庚醫院車醫師針對桃園縣10所小學8997位以上學童的調查指出6-12歲的孩童在過去一個月內，曾有一次以上尿床的盛行率為5.5%，其中白天也有尿溼褲子現象者有0.5%。7歲（一年級）為9.3%，8歲6.6%，9歲4.7%，10歲3.1%，11歲1.6%，12-13歲0.6%。男孩為女孩的2倍。我們建議需要開始醫療諮商的年齡為5足歲，需要治療的年齡為6足歲。尿床的評估應包括病史詢問，理學檢查和實驗室檢查。尿液分析，尿比重和超音波為必要之實驗室檢查。上述評估本會製作一個可供勾選的簡表以運用於忙碌的門診。此外本會也製作一個單一症狀尿床的治療流程圖作為臨床快速查詢之用。尿床常用的治療可分為二大類：行為療法—鬧鈴治療等，和藥物治療—人工合成抗利尿激素DDAVP與三環素imipramine。Imipramine在台灣雖仍被建議為尿床用藥之一，本會特別對它的可能藥毒性與致死性提出警示。治療1-3個月後要評估治療效果。治療效果不佳者，需要以尿動力學檢查等重新評估，再作適當調整。

關鍵字

夜間遺尿 ； 尿床 ； 治療建議

並列摘要

The consensus and treatment guideline of enuresis of the study group of enuresis in Taiwan (SGET) is reported. This report is adopted from the published reports and the clinical experiences of the members of the SGET. The prevalence rate of enuresis in Taiwan is similar to that of the western societies. Cher reported 5.5%of the 8997 school children aged between 6 and 12 years had at least one episode of enuresis in the last month. Boys were affected twice common as girls. Diurnal enuresis was noted in 0.5% of the children. The prevalence rate of enuresis of various ages were as the following: 7y/o: 9.3%, 8y/o:6.6%,9y/o4.7%，10y/o3.1%，11y/o1.6%，12-13y/o0.6%. We recommend medical consultation at the age of 5 years and treatment at the age of 6 years. Evaluation of the enuretic children includes history taking, physical examination and laboratory investigations. Urinalysis, urine specific gravity and office ultrasound are essential tests in the first few visits. A checklist is provided for quick reference in the busy clinics. An algorithm is proposed as the treatment guideline of monosymptomatic enuresis. The two main options of treatment are behavioral modification-alarm therapy, and pharmacotherapy-antidiuretic hormone and imipramine. Imipramine is still recommended in the treatment of enuresis because of its relative safety in Taiwan. However, the potential toxicity of imipramine is highlighted and warned. Evaluation of treatment response is suggested after a period of 1-3 months. Extensive studies, such as urodynamic examinations, are suggested for refractory enuresis. Treatment strategies should be modified accordingly.

並列關鍵字

enuresis ； treatment guideline