小儿尿失禁及遗尿课件

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1、小兒尿失禁及遺尿的照護及處置彰化基督教醫院戴慧龍DevelopmentofBladderControl(I)Before1-year-old:-Novoluntarycontrolofvoidingandhavelittlesensationofeitherfillingorvoiding.Thefirstyearoflife:-Developingsensation-Witnessbylevelsofdiscomfortwhenthebladderisfullandreliefwhentheyvoid.Developmento

2、fBladderControl(II)Before2-year-old-Numbersofvoidingepisodesperdaydecreasesfromabout20toaround10.2-4yearsofage(toddlers)-Todeveloptruebladdercontrol-ThefirstmanifestationofthiscontrolistheabilitytodeferthedesiretovoidDevelopmentofBladderControl(III)Preschoolers(4-6yea

3、rsofage)-Completelytrainedduringtheday-Occasionaldaytimewettingarenotunusual-Occasionalwetting(onceeveryfewweeks)shouldbetolerated.-IfoccursonceperweekEvaluationDevelopmentofBladderControl(IV)Normalschool-agechildren-Shouldhaveuniformdaytimecontinence-Shouldbeabletoc

4、onformtoschoolschedulesandvoidatthetimesapproximatewiththeirpeers-Recurrentdaytimewettingisalwaysabnormalanddeservesmedicalattention.ThegeneralorderofdevelopmentofurineandfecalcontinenceNighttimefecalcontrolDaytimefecalcontinenceDaytimeurinarycontinenceNighttimeurinar

5、ycontinenceIncontinenceisalsocalledEnuresisPrimaryenuresisreferstowettinginapersonwhohasneverbeendryatleast6months.Secondaryenuresisreferstowettingthatbeginsafteratleast6monthsofdryness.Nocturnalenuresisreferstowettingthatusuallyoccursduringsleep(nighttimeincontinence

6、)Diurnalenuresisreferstowettingwhenawake(daytimeincontinence).尿床－身體的自動淨水處理廠出狀況了！突然發生的尿床，只有在太累、不舒服或經歷令人難過的事時才會尿床者，稱為短暫性尿床（Transientwetting）幾乎每晚都會發生的尿床，稱為持續性尿床（Persistentwetting）一個晚上尿床好幾次，稱為多發性尿床（Multiplewetting）不論白天或晚上都會尿床，稱為混合型尿床（Bedwettingwithassociateddaywetting）Cau

7、sesofChildhoodIncontinenceBladderoutletobstructionConstipationDetrusorinstabilityDiabetesmellitusDiabetesinsipidusEctopicureterInfectionNeurogenicbladderSleepdisorderPsychologicstressVaginitisNeurogeniccausesofIncontinenceCongenitalSpinaldysraphismTetheredcordsyndrome

8、AcquiredSpinalcordtumorsPelvicsurgeryTransversemyelitisSpinalcordinjuryWhatCausesNighttimeIncontinence?Afterage5atnight.More