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子供
子供

子供の夜尿症の対策と解決法

子供

もう小学生なのに、今日もまた、、。親とって辛い子供の夜尿症ですが、本人ももう大きくなっている分自覚して恥ずかしい思いをしています。赤ちゃんならともかく、なぜ子供の夜尿症が治らないのでしょうか?

ある調査によると、夜尿症は小学校低学年で約10%、小学校高学年で約5%にみられます。12歳を過ぎると、その多くは消失していきますが、成人になっても夜尿がみられる場合があります(0.1~0.3%程度)夜尿症はおおむね10歳前後までは10人に1人位の割合で起こっておるようですね。今回は子供の夜尿症の対策と解決方法をご紹介しましょう。

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夜尿症とおねしょの違い

考える

「おねしょ」と「夜尿症」は、夜寝ている間に無意識に排尿してしまうということでは同じですが、その違いのポイントは年齢です。つまり、幼児期の夜尿をおねしょといい、6~7歳(小学校入学後)以後の夜尿を夜尿症というのが一般的です。6~7歳になっても夜尿がつづく場合は、医師による生活指導や、投薬療法など、適切な対策をとったほうがよい場合があります。 生まれて2歳頃まで赤ちゃんは毎晩おねしょをします。2歳あたりからトイレトレーニングが始まり、その割合は年齢とともに減っていきますが、2~3歳児ではその1/2~1/3、4歳児では1/4の子供がまだおねしょをしています。

夜尿症の治り方

自然治癒

おねしょ(夜尿症)はそのうち治ると、よく言われます。特別に治療をしなくても、大体12歳を過ぎるころには、夜尿は自然に見られなくなります。しかし、成人まで続くこともまれではありません。あくまでも目安ですが、夜尿症の自然治癒率(特に何も対応しない場合)は、1つ年をとるごとに10~15%の割合で減少するとされています。

7~8歳で週の半分以上夜尿をしている子どもを対象(66名)に、夜尿症の自然治癒率を調べたところ、約50%の子どもで夜尿が治った時期は12歳、約90%の子どもで夜尿が治った時期は15歳という報告もあります。あまり神経質にならずに親も子供もおおらかな気持ちで考える事が大切です。

医療治癒

夜尿症をなるべく早く治したい、治って欲しいと思われる場合は、やはり病院で投薬や生活改善等の治療を受けると良いでしょう。病院で治療した場合は、1年で約50%、2年で約80%、3年で約90%完治するという報告もあります。

医療による夜尿症の治療方法

おねしょアラーム

このアラームは、寝る前に子供のパンツに小さなセンサーをつけ、おしっこでパンツがぬれるとアラームが鳴って子供を起こす仕組みになっています。ただし最初はパンツが濡れても自分で起きることはまずないので、そばで両親が寝ている必要があります。アラームが鳴ったら、親が起こしてトイレまで連れて行って完全に排尿させる必要があります。根気と忍耐、時間がかかる方法です。

両親と子供の両方に最低3ヶ月は続ける意欲がないと挫折してしまうでしょう。8歳以上の子供で、本人が強く望まないとこの方法は子供にとってストレスになりかねません。しかし効果が出てくると夜中に起きなくても朝までおねしょをしないでおしっこをためられるようになります。

デスモプレシン(DDAVP)ホルモン補充法

夜尿症の子供の多くは夜間に多尿になっています。人間の体の中では尿量をへらすために抗利尿ホルモンというホルモンが分泌されていますが、夜尿症の子供では夜間のこのホルモンの分泌が少ない場合があります。そのような場合は寝る前にこのホルモンを補ってあげると夜尿が生じません。

現在は鼻に噴霧するスプレータイプのものが出ていますから寝る前に医師から指示されたとおりの回数を噴霧してください。約50%の子供に効果がありますが、やめると元に戻ることが多いのが欠点です。修学旅行などここぞという場合に使用しても良いでしょう。この薬を使うときは夕食後の水分は控えるようにしてください。

ポラキス(塩酸オキシブチニン)投薬治療法

この薬は膀胱に働いて膀胱の収縮を抑制しリラックスさせるはたらきがあります。それにより膀胱がためられる尿量が増えることが期待できます。膀胱の働きが不安定な昼間のおもらしには効くことが多いのですが、通常夜尿症では単独使用では効果がありません。デスモプレシンやおねしょアラームと組み合わせて使用します。子どもでの副作用は少ないのですがときに頭痛、めまい、のどの渇きを訴えます。

トフラニール(塩酸イミプラミン)投薬治療法

この薬は三環系抗うつ薬と呼ばれうつ病に使われている薬ですが以前より子供のおねしょの治療にも使われています。夜尿症に対する作用については個人差がありますがポラキスと組み合わせて投与したりします。誤って薬を大量に飲んで重篤な副作用を起こしたことも報告されていますので使用するときは注意が必要です。

新 おねしょなんかこわくない―子どもから大人まで最新の治療法
帆足 英一
小学館
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まとめ

夜尿症は小学生でも約10人に1人に見られます。自然治癒する症状ですが、ごくまれに大人になるまで続く場合があります。親の負担も大きいですが、本人のストレスや性格形成に影響が出る場合もあります。本人が希望するようであれば、病院で治療を受けても良いでしょう。

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