\u00c7ocukluk \u00e7a\u011f\u0131nda \u00fcriner sistem ile ilgili en s\u0131k g\u00f6r\u00fclen problemlerden birisi geceleri alt\u0131n\u0131 \u0131slatmad\u0131r. T\u0131p dilinde \u2018en\u00fcrezis nokt\u00fcrna\u2019 denir. En\u00fcrezis; \u00e7i\u015f ka\u00e7\u0131rma, \u2018nokt\u00fcrna\u2019; geceleri anlam\u0131nda kullan\u0131l\u0131r. Hem gece, hem g\u00fcnd\u00fcz var ise \u2018en\u00fcrezis di\u00fcrnal\u2019 terimi kullan\u0131l\u0131r.<\/p>\n
En\u00fcrezis nokt\u00fcrna \u00fclkemizde s\u0131k\u00e7a g\u00f6r\u00fclmesine ve ciddi bir problem olmas\u0131na ra\u011fmen, anne veya baban\u0131n da \u00e7ocukluk d\u00f6neminde de ayn\u0131 sorun ile kar\u015f\u0131la\u015fm\u0131\u015f ve kendili\u011finden (ileri ya\u015flarda) d\u00fczelebildi\u011fini bildikleri i\u00e7in \u00e7o\u011fu zaman doktora ba\u015fvurmazlar.<\/p>\n
Alt\u0131n\u0131 \u0131slatan \u00e7ocuk geceleri sa\u011fl\u0131kl\u0131 bir uyku uyuyamad\u0131\u011f\u0131 i\u00e7in g\u00fcnd\u00fczleri yeterli derecede dikkatini toplayamayabilir ve bu ders ba\u015far\u0131s\u0131n\u0131 da etkiler. Alt\u0131n\u0131 \u0131slatman\u0131n yaratt\u0131\u011f\u0131 stresli durum nedeniyle ileride anksiyete (endi\u015fe, kayg\u0131) ve kendine g\u00fcven sorunu gibi psikolojik sorunlar ortaya \u00e7\u0131kabilir. Ebeveynler de ayn\u0131 durumu ya\u015farlar. Tabii ki \u00e7ama\u015f\u0131rlar\u0131n y\u0131kanmas\u0131, harcanan deterjan, su ve elektrik, \u00e7evre kirlili\u011fi i\u015fin ayr\u0131 bir ekonomik taraf\u0131.<\/p>\n
Tan\u0131mlama olarak, 5 ya\u015f\u0131n \u00fczerindeki \u00e7ocuklarda uykuda gece alt\u0131n\u0131 \u0131slatma enuresis nokt\u00fcrna olarak tan\u0131mlan\u0131r.<\/p>\n
En\u00fcrezis nokt\u00fcrna basit (monosemptomatik) veya komplike (monosemptomatik olmayan) \u015feklinde iki alt grupta incelenmelidir. Monosemptomatik te gece yata\u011f\u0131 \u0131slatma d\u0131\u015f\u0131nda g\u00fcn i\u00e7inde herhangi bir belirti yoktur. Monosemptomatik olmayan enuresis nokt\u00fcrna ise gece alt\u0131n\u0131 \u0131slatma yan\u0131nda, g\u00fcnd\u00fczleri ani s\u0131k\u0131\u015fma hissi, s\u0131k idrara \u00e7\u0131kma, g\u00fcnd\u00fcz idrar ka\u00e7\u0131rma, kronik kab\u0131zl\u0131k gibi bulgular\u0131n e\u015flik etmesi olarak tan\u0131mlan\u0131r.<\/p>\n
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Alt\u0131n\u0131 \u0131slatma neden olur?<\/strong><\/p>\n \u00a0<\/strong><\/p>\n Uyanma bozuklu\u011fu<\/p>\n Gece d\u00fc\u015f\u00fck mesane kapasitesi ve mesane kaslar\u0131n\u0131n a\u015f\u0131r\u0131 kas\u0131lmas\u0131<\/p>\n Artm\u0131\u015f gece idrar miktar\u0131 (Nokt\u00fcrnal poli\u00fcri)<\/p>\n <\/p>\n Diagnosis<\/strong><\/p>\n Sadece geceleri idrar ka\u00e7\u0131rma var, g\u00fcnd\u00fczleri bir \u015fikayeti yok ise sadece \u00fcriner sistem ultrasonografisi ve idrar tetkiki yap\u0131l\u0131r. Bu tetkikler normal ise basit enurezis olarak kabul edilir.<\/p>\n <\/p>\n Treatment<\/strong><\/p>\n \u00a0<\/strong><\/p>\n Davran\u0131\u015f tedavisi<\/strong><\/p>\n \u00a0<\/strong><\/p>\n En\u00fcrezis nokt\u00fcrna tan\u0131s\u0131 konulan hastan\u0131n tedavisinin ilk a\u015famas\u0131nda; doktor, ebeveynler, geceleri \u00e7ocuk ile ayn\u0131 evde kalan; bak\u0131c\u0131, b\u00fcy\u00fckanne, b\u00fcy\u00fckbaba ve \u00e7ocuk bir arada konu\u015fulmal\u0131d\u0131r. \u00c7ocu\u011fu motive edecek c\u00fcmleler kurularak tedaviye ba\u015flan\u0131l\u0131r. Alt\u0131na i\u015femenin su\u00e7 olmad\u0131\u011f\u0131, annesinin veya babas\u0131n\u0131n da zaman\u0131nda i\u015fedi\u011fini ve uykular\u0131n\u0131n a\u011f\u0131r olmas\u0131na ra\u011fmen \u015fu anda i\u015femedikleri anlat\u0131lmal\u0131.<\/p>\n Davran\u0131\u015f tedavisinde hasta uyuduktan belli bir saat sonra i\u015fettirilir. Ak\u015fam s\u0131v\u0131 al\u0131m\u0131 k\u0131s\u0131tlan\u0131r. Buna ra\u011fmen alt\u0131na i\u015fiyor ise medikal tedavi deste\u011fine ge\u00e7ilir.<\/p>\n <\/p>\n Medikal tedavi<\/strong><\/p>\n \u00a0<\/strong><\/p>\n Uyanma g\u00fc\u00e7l\u00fc\u011f\u00fc olanda alarm tedavisi<\/p>\n Desmopressin<\/p>\n Mesane kapasitesi d\u00fc\u015f\u00fck olanda antikolinerjik<\/p>\n <\/p>\n Alarm tedavisi:<\/strong> uyanma problemi olanlarda etkili. Zaman i\u00e7inde mesane doldu\u011funda hen\u00fcz idrar ka\u00e7\u0131rmadan uyanman\u0131n \u00f6\u011frenilmesini sa\u011flar. Aile ve \u00e7ocugun motivasyonu \u00f6nemlidir. Her alarm \u00e7ald\u0131\u011f\u0131nda \u00e7ocuk tuvalete g\u00f6t\u00fcr\u00fclmeli. Ailelerin %10-30 u tedaviyi tamamlayamamaktad\u0131r.<\/p>\n \u00a0<\/strong><\/p>\n Desmopressin:<\/strong> idrar \u00fcretimini azalt\u0131p konsantrasyonunu art\u0131r\u0131yor. Yar\u0131 \u00f6mr\u00fc 1.5- 3 saat. Nokt\u00fcrnal poli\u00fcrisi olanlarda ideal tedavidir. Ba\u015far\u0131 oran\u0131 %60-70. Evden ge\u00e7ici s\u00fcrelerde ayr\u0131lmalarda, okul gezilerinde kullan\u0131ld\u0131\u011f\u0131nda hemen etkilidir. Tablet, melt (dil alt\u0131nda eriyen), nazal spray. Melt dozu 120-240 mikrogramd\u0131r (maksimum 360 mikrogram). Yatmadan yar\u0131m saat 1 saat once verilmeli. 3 ayda bir 1-3 defa tedaviye ara verilerek kontrol edilir. S\u0131v\u0131 k\u0131s\u0131tlamas\u0131 yap\u0131lmal\u0131. Yatmadan 1 saat once s\u0131v\u0131 al\u0131m\u0131 k\u0131s\u0131tlanmal\u0131.<\/p>\n <\/p>\n Antikolinerjikler:<\/strong> Mesane kapasitesi azalm\u0131\u015f, detrusor aktivitesi artm\u0131\u015f,\u00a0 veya g\u00fcnd\u00fcz de semptomlar\u0131 var ise\u00a0 desmopressine yan\u0131ts\u0131z vakalarda, \u00f6zellikle gece ikiden fazla olan ka\u00e7\u0131rmalarda kullan\u0131l\u0131r.<\/p>\n <\/p>\n \u0130zlem<\/strong>. Mutlaka 2-4 hafta i\u00e7inde kontrole \u00e7a\u011fr\u0131l\u0131r ve hastan\u0131n uyumu g\u00f6zden ge\u00e7irilir.<\/p>\n <\/p>\n <\/p>","protected":false},"excerpt":{"rendered":" \u00c7ocukluk \u00e7a\u011f\u0131nda \u00fcriner sistem ile ilgili en s\u0131k g\u00f6r\u00fclen problemlerden birisi geceleri alt\u0131n\u0131 \u0131slatmad\u0131r. T\u0131p dilinde \u2018en\u00fcrezis nokt\u00fcrna\u2019 denir. En\u00fcrezis; \u00e7i\u015f ka\u00e7\u0131rma, \u2018nokt\u00fcrna\u2019; geceleri anlam\u0131nda kullan\u0131l\u0131r. Hem gece, hem g\u00fcnd\u00fcz var ise \u2018en\u00fcrezis di\u00fcrnal\u2019 terimi kullan\u0131l\u0131r. En\u00fcrezis nokt\u00fcrna \u00fclkemizde s\u0131k\u00e7a g\u00f6r\u00fclmesine ve ciddi bir problem olmas\u0131na ra\u011fmen, anne veya baban\u0131n da \u00e7ocukluk d\u00f6neminde de ayn\u0131 […]<\/p>","protected":false},"author":1,"featured_media":513,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,24],"tags":[28,27,26,25,29],"class_list":["post-512","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-genel","category-uroloji","tag-adana-cocuk-cerrahi","tag-adana-cocuk-urolog","tag-altini-islatan-cocuk","tag-altini-islatma-neden-olur","tag-cocuk-urolojisi"],"yoast_head":"\n