Exploratory Study On Precise Treatment Of Children With Primary Nocturnal Enuresis

Objective: First,we evaluate the patients' family and social status,sleep condition,behavioral development,central nervous system development,and clinical features.Then we provide precise treatment for children with primary nocturnal enuresis(PNE)based on the multiple factors obtained from systematic evalution.Finally,we try to analyse the relevant factors that would influence the effect of treatment.Methods: The patient group included 262 children with PNE,they and their caregivers filled in the questionnaire with the help of pediatricians.The control group consisted of 103 healthy children above 5 years-old who went for a physical examination in Shanghai Children's Medical Center.Thirty patients and thirty normal children went through the fMRI test.The multivariable logistic regression was used to evaluate the potential risk factors of childhood PNE.Afterwords,we made individualized precise treatment regimen for children in precise treatment group to evaluate the effect.Results: Totally,there were 262 children with PNE and 103 healthy children participant participant in our study,in the multivariable logistic regression,we found that long-time TV watching(OR=5.801),negligent parenting style(OR=3.505),family history of PNE(OR=8.407),sleep-talking(OR=8.407),sleep-walking(OR=36.673),sleep with prone position(OR=2.262)were risk factors for school age children to co-occur PNE.Moreover,we found four brain regions with a reduced connection efficiency with thalamus in children with PNE,that were cerebellum posterior lobe,frontal lobe,temporal lobe and precentral gyrus.The connection efficiency between thalamus and precentral gyrus was positively related to the micturition desire awaking events while sleeping.In precise treatment group,the cure rate was 41.7%(25 in 60 children),50% children improved(30 in 60 children),and 19.4%(6 in 31 children)cured,58.1% children improved(18 in 31 children)in control group.The difference of the cure rate between two groups was significant,moreover the frequency of having bedwetting could influence the cure rate.Conclusion: The potential risk factors of childhood PNE included long time TV watching,negligent parenting style,family history of PNE,sleep-talking,sleep-walking,sleep with prone position and abnormal thalamus-based functional connectivity.The precise treatment was effective for children with PNE,and the the frequency of having bedwetting could negatively influence the cure rate.