{"id":1094,"date":"2021-02-24T19:25:29","date_gmt":"2021-02-24T18:25:29","guid":{"rendered":"https:\/\/learningtoys.cz\/blog\/?p=1094"},"modified":"2021-02-24T19:26:07","modified_gmt":"2021-02-24T18:26:07","slug":"nocni-pomocovani-kdy-resit-a-jake-jsou-priciny","status":"publish","type":"post","link":"https:\/\/learningtoys.cz\/blog\/nocni-pomocovani-kdy-resit-a-jake-jsou-priciny\/","title":{"rendered":"No\u010dn\u00ed pomo\u010dov\u00e1n\u00ed – kdy \u0159e\u0161it a jak\u00e9 jsou p\u0159\u00ed\u010diny?"},"content":{"rendered":"
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Pro\u010d se d\u00edt\u011b v noci po\u010d\u016fr\u00e1v\u00e1, kdy\u017e jeho vrstevn\u00edci u\u017e d\u00e1vno sp\u00ed bez plenek? D\u016fvod\u016f je cel\u00e1 \u0159ada. Opo\u017ed\u011bn\u00fd v\u00fdvoj i genetick\u00e9 dispozice.<\/strong><\/h3>\n
Mnoho rodi\u010d\u016f se pt\u00e1, pro\u010d se jejich d\u00edt\u011b st\u00e1le po\u010d\u016fr\u00e1v\u00e1. D\u016fvod\u016f je v\u00edce a s pravou p\u0159\u00ed\u010dinou by m\u011bl poradit hlavn\u011b l\u00e9ka\u0159. Poj\u010fme si ale shrnout z\u00e1kladn\u00ed informace.<\/div>\n<\/div>\n

Co je no\u010dn\u00ed pomo\u010dov\u00e1n\u00ed?<\/strong><\/h2>\n
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No\u010dn\u00ed enur\u00e9za (no\u010dn\u00ed pomo\u010dov\u00e1n\u00ed) je \u010dast\u00fdm probl\u00e9mem d\u011bt\u00ed na cel\u00e9m sv\u011bt\u011b. Jej\u00ed vznik je spojen se soci\u00e1ln\u00edm a environment\u00e1ln\u00edm stresem a genetickou z\u00e1t\u011b\u017e\u00ed. Mezi hlavn\u00ed p\u0159\u00ed\u010diny ale pat\u0159\u00ed porucha regulace no\u010dn\u00ed produkce mo\u010de a zv\u00fd\u0161en\u00e1 aktivita \u010di dr\u00e1\u017edivost mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e spole\u010dn\u011b s nerovnom\u011brn\u00fdm nebo opo\u017ed\u011bn\u00fdm dozr\u00e1v\u00e1n\u00edm reflex\u016f \u0159\u00edd\u00edc\u00edch funkci mo\u010dov\u00fdch cest. U t\u011bchto d\u011bt\u00ed je nezbytn\u00e9 v prvn\u00ed \u0159ad\u011b spr\u00e1vn\u011b ur\u010dit povahu enur\u00e9zy, proto\u017ee l\u00e9\u010debn\u00e9 postupy se u jednotliv\u00fdch typ\u016f pomo\u010dov\u00e1n\u00ed li\u0161\u00ed, tedy odli\u0161it prim\u00e1rn\u00ed monosymptomatickou enur\u00e9zu (nejsou jin\u00e9 obt\u00ed\u017ee krom\u011b no\u010dn\u00edho pomo\u010dov\u00e1n\u00ed a pomo\u010dov\u00e1n\u00ed trv\u00e1 kontinu\u00e1ln\u011b od narozen\u00ed)\u00a0 od polysymptomatick\u00e9 (nonmonosymptomatick\u00e9) enur\u00e9zy \u2013 slo\u017eit\u011bj\u0161\u00ed formy poruchy doln\u00edch mo\u010dov\u00fdch cest. U t\u00e9to slo\u017eit\u011bj\u0161\u00ed enur\u00e9zy nach\u00e1z\u00edme krom\u011b dominuj\u00edc\u00edho p\u0159\u00edznaku no\u010dn\u00edho pomo\u010dov\u00e1n\u00ed i denn\u00ed obt\u00ed\u017ee (viz n\u00ed\u017ee), infekce mo\u010dov\u00fdch cest atd.Tzv. sekund\u00e1rn\u00ed enur\u00e9za vznik\u00e1 po del\u0161\u00edm ne\u017e \u0161estim\u011bs\u00ed\u010dn\u00edm intervalu bez pomo\u010den\u00ed. Z\u00e1kladn\u00ed roli v l\u00e9\u010db\u011b hraje \u00faprava mo\u010dov\u00fdch reflex\u016f a p\u0159\u00edjmu tekutin. Farmakoterapie je rezervov\u00e1na jen pro n\u011bkter\u00e9 indikace. Nej\u010dast\u011bji pou\u017e\u00edv\u00e1me l\u00e9ky, kter\u00e9 sni\u017euj\u00ed no\u010dn\u00ed produkci mo\u010de. V\u00fdznamnou roli v l\u00e9\u010db\u011b hraj\u00ed tak\u00e9 tzv enuretick\u00e9 alarmy.\u00a0Zdroj: MUDr. Zden\u011bk D\u00edt\u011b, FEAPU, Urologick\u00e1 klinika VFN a 1.LF UK,TH klinika, Praha<\/em><\/p>\n<\/div>\n<\/div>\n

Co m\u016f\u017eou b\u00fdt p\u0159\u00ed\u010diny po\u010d\u016fr\u00e1v\u00e1n\u00ed?<\/strong><\/h2>\n
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Opo\u017ed\u011bn\u00e9 dozr\u00e1v\u00e1n\u00ed centr\u00e1ln\u00edho nervov\u00e9ho syst\u00e9mu – <\/strong>Mezi prvn\u00edm a druh\u00fdm rokem v\u011bku d\u00e1le dozr\u00e1v\u00e1 schopnost vn\u00edmat pocit napln\u011bn\u00ed mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e a zlep\u0161uje se kontrola reflex\u016f mo\u010den\u00ed. \u0158\u00edd\u00edc\u00ed vliv mozku dozr\u00e1v\u00e1 do t\u0159et\u00edho roku v\u011bku d\u00edt\u011bte. U \u0159ady d\u011bt\u00ed se da\u0159\u00ed odhalit n\u011bkter\u00e9 zn\u00e1mky a\u017e opakovan\u00fdmi c\u00edlen\u00fdmi dotazy, nebo\u0165 denn\u00ed symptomatologie (urgence, \u010dast\u00e9 mo\u010den\u00ed, p\u0159eru\u0161ovan\u00e9 mo\u010den\u00ed) mohou b\u00fdt v\u00a0projevech v\u00fdrazn\u011b potla\u010deny.<\/p>\n

Chlope\u0148 zadn\u00ed mo\u010dov\u00e9 trubice – <\/strong>Vrozen\u00e1 porucha u chlapc\u016f, dob\u0159e zn\u00e1m\u00e1 mezi urology, zp\u016fsoben\u00e1 blanitou p\u0159ep\u00e1\u017ekou v\u00a0mo\u010dov\u00e9 trubici v \u00a0oblasti prostaty, zp\u016fsobuj\u00edc\u00ed v\u00a0nejt\u011b\u017e\u0161\u00edch p\u0159\u00edpadech ji\u017e p\u0159ed porodem z\u00e1va\u017en\u00e9 m\u011bstn\u00e1n\u00ed v\u00a0mo\u010dov\u00fdch cest\u00e1ch spojen\u00e9 s\u00a0posti\u017een\u00edm ledvin nebo se m\u016f\u017ee manifestovat v\u00a0daleko m\u00edrn\u011bj\u0161\u00ed podob\u011b obt\u00ed\u017eemi s mo\u010den\u00edm, \u010dasto a\u017e v\u00a0p\u0159ed\u0161koln\u00edm \u010di ran\u00e9m \u0161koln\u00edm v\u011bku. Mezi nejv\u011bt\u0161\u00ed stesky posti\u017een\u00fdch d\u011bt\u00ed \u00a0pat\u0159\u00ed krom\u011b pomo\u010dov\u00e1n\u00ed \u010dast\u00e9 nucen\u00ed na mo\u010den\u00ed, slab\u00fd mo\u010dov\u00fd proud a urgence.<\/p>\n

Z\u00fa\u017een\u00e1 mo\u010dov\u00e1 trubice u d\u00edvek – <\/strong>Obdobn\u011b jako u chlapc\u016f s\u00a0chlopn\u00ed zp\u016fsobuje oslaben\u00ed mo\u010dov\u00e9ho proudu, kter\u00e9 m\u016f\u017ee b\u00fdt prov\u00e1zeno druhotn\u011b podr\u00e1\u017ed\u011bn\u00fdm mo\u010dov\u00fdm m\u011bch\u00fd\u0159em s\u00a0urgencemi a \u00faniky mo\u010de.<\/p>\n

Stres – <\/strong>Dnes ji\u017e je dostate\u010dn\u011b prok\u00e1zan\u00fd vliv stresu na vznik v\u011bt\u0161inou tzv druhotn\u00e9ho (sekund\u00e1rn\u00edho) pomo\u010dov\u00e1n\u00ed. U mal\u00e9 \u010d\u00e1sti pacient\u016f m\u00e1 enureza\u00a0 jednozna\u010dn\u011b psychopatologick\u00e9 pozad\u00ed (narozen\u00ed sourozence, rozvod rodi\u010d\u016f, \u00famrt\u00ed v rodin\u011b, probl\u00e9my ve \u0161kole atd.)<\/p>\n

\"\"<\/p>\n

Jak\u00e1 vy\u0161et\u0159en\u00ed odhal\u00ed, pro\u010d se d\u00edt\u011b v noci po\u010d\u016fr\u00e1v\u00e1<\/strong><\/h2>\n

Pacienta s\u00a0monosymptomatickou no\u010dn\u00ed enurezou za\u010d\u00edn\u00e1me vy\u0161et\u0159ovat \u00a0ve v\u011bku p\u011bti let. Neinvazivn\u00ed vy\u0161et\u0159ovac\u00ed metody jsou ve v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f dosta\u010duj\u00edc\u00ed k posouzen\u00ed\u00a0 funk\u010dn\u00edho stavu\u00a0 DMC. Sou\u010dasn\u011b prov\u00e1d\u00edme i z\u00e1kladn\u00ed laboratorn\u00ed vy\u0161et\u0159en\u00ed. Nen\u00ed tedy zapot\u0159eb\u00ed ob\u00e1vat se bolestiv\u00fdch z\u00e1krok\u016f.<\/p>\n

Jak po\u010d\u016fr\u00e1v\u00e1n\u00ed l\u00e9\u010dit?<\/strong><\/h2>\n
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Dobr\u00e1 zpr\u00e1va pro rodi\u010de, no\u010dn\u00ed po\u010d\u016fr\u00e1v\u00e1n\u00ed je u vt\u011b\u0161iny d\u011bt\u00ed l\u00e9\u010diteln\u00e9. Nutn\u00e9 jen sv\u011b\u0159it se do rukou odborn\u00edka. <\/strong>U v\u011bt\u0161iny d\u011bt\u00ed je pr\u016fb\u011bh enurezy benign\u00ed s tendenc\u00ed ke spont\u00e1nn\u00ed \u00faprav\u011b, u mal\u00e9 \u010d\u00e1sti pacient\u016f je v\u0161ak no\u010dn\u00ed pomo\u010dov\u00e1n\u00ed pouze jedn\u00edm z projev\u016f komplexn\u011bj\u0161\u00edho onemocn\u011bn\u00ed a zanedb\u00e1n\u00ed\u00a0 platn\u00fdch diagnostick\u00fdch a l\u00e9\u010debn\u00fdch postup\u016f m\u016f\u017ee v\u00e9st k z\u00e1va\u017en\u011bj\u0161\u00edmu posti\u017een\u00ed.<\/p>\n

Re\u017eimov\u00e1 l\u00e9\u010dba, alarmy – <\/strong>Prvn\u00edm krokem ve snaze dos\u00e1hnout zlep\u0161en\u00ed funkce mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e d\u00edt\u011bte s enurezou\u00a0 jsou v naprost\u00e9 v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f\u00a0re\u017eimov\u00e1 opat\u0159en\u00ed<\/strong>. Doporu\u010dujeme mo\u010den\u00ed v maxim\u00e1ln\u011b dvouhodinov\u00fdch intervalech, vklidu bez pou\u017eit\u00ed b\u0159i\u0161n\u00edho lisu s pokud mo\u017eno kompletn\u00ed relaxac\u00ed\u00a0 p\u00e1nevn\u00edho dna a kompletn\u00edm domo\u010den\u00edm.<\/p>\n

Farmakoterapie – Desmopresin<\/strong>\u00a0 je p\u016fvodn\u00ed \u010desk\u00fd l\u00e9k, vyvinut\u00fd v r.1968 Zaoralem, pou\u017e\u00edvan\u00fd v l\u00e9\u010db\u011b enurezy \u00fasp\u011b\u0161n\u011b ji\u017e t\u00e9m\u011b\u0159 dvacet rok\u016f. Omezuje no\u010dn\u00ed produkci mo\u010di ledvinami. Jedn\u00e1 se o z\u00e1kladn\u00ed l\u00e9k (l\u00e9k prvn\u00ed volby) v l\u00e9\u010db\u011b no\u010dn\u00edho pomo\u010dov\u00e1n\u00ed. Nejlep\u0161\u00ed\u00a0 v\u00fdsledky jsou dosahov\u00e1ny u d\u011bt\u00ed s prim\u00e1rn\u00ed, monosymptomatickou\u00a0 enurezou.<\/p>\n

Opera\u010dn\u00ed l\u00e9\u010dba – <\/strong>Opera\u010dn\u00ed l\u00e9\u010dba je vyhrazena pro p\u0159\u00edpady t\u011b\u017e\u0161\u00edho a komplexn\u00edho posti\u017een\u00ed mo\u010dov\u00fdch cest, nej\u010dast\u011bji komplikovan\u00e9, na konzervativn\u00ed l\u00e9\u010dbu nereaguj\u00edc\u00ed dysfunkce, vrozen\u00e9 v\u00fdvojov\u00e9 vady s obstrukc\u00ed mo\u010dov\u00fdch cest (chlopn\u011b zadn\u00ed uretry), \u010dasto prov\u00e1zen\u00e9 zn\u00e1mkami posti\u017een\u00ed horn\u00edch mo\u010dov\u00fdch cest.<\/p>\n

\"\"<\/a>Rehabilita\u010dn\u00ed l\u00e9\u010dba – <\/strong>Relaxa\u010dn\u00ed cvi\u010den\u00ed p\u00e1nevn\u00edho dna maj\u00ed bezpochyby pozitivn\u00ed efekt na n\u00e1cvik spr\u00e1vn\u00e9ho uvol\u0148ov\u00e1n\u00ed p\u00e1nevn\u00edho dna. Nej\u010dast\u011bj\u0161\u00ed metodou je cvi\u010den\u00ed pomoc\u00ed zp\u011btn\u00e9 vazby (biofeedback). Nezbytnou podm\u00ednkou \u00fasp\u011b\u0161nosti t\u00e9to l\u00e9\u010dby je trp\u011blivost a pozitivn\u00ed motivace pacienta a sou\u010dasn\u011b i intelekt umo\u017e\u0148uj\u00edc\u00ed pochopen\u00ed podstaty cvi\u010den\u00ed.Proto je pou\u017eitelnost t\u00e9to rehabilitace v\u011bt\u0161inou omezena na \u0161koln\u00ed d\u011bti a dosp\u011bl\u00e9 pacienty.<\/p>\n

Psychoterapie, behavior\u00e1ln\u00ed l\u00e9\u010dba – <\/strong>Pat\u0159\u00ed do rukou zku\u0161en\u00e9ho psychoterapeuta.Jejich \u00falohu vid\u00edme zejm\u00e9na v anal\u00fdze psychosoci\u00e1ln\u00ed situace, sn\u00ed\u017een\u00ed pocitu viny a zv\u00fd\u0161en\u00ed sebe\u00facty pacienta.<\/p>\n

Pomocn\u00edci p\u0159i pomo\u010dov\u00e1n\u00ed<\/strong><\/h2>\n

Krom\u011b v\u00fd\u0161e zm\u00edn\u011bn\u00e9ho je t\u0159eba b\u00fdti trp\u011bliv\u00ed a po\u010d\u00edtat s nehodami i nad\u00e1le. Skv\u011ble v\u00e1m poslou\u017e\u00ed CHR\u00c1NI\u010cE MATRACE<\/a>. Jde o speci\u00e1ln\u00ed potah na matrace do d\u011btsk\u00e9 post\u00fdlky. Chr\u00e1ni\u010de matrace jsou vyrobeny ze 100% bavlny a chr\u00e1n\u00ed matraci<\/strong>, ale hlavn\u011b va\u0161e d\u00edt\u011b p\u0159ed jak\u00fdmkoli vlhkem – promo\u010den\u00ed z pleny \u010di rozlit\u00ed n\u00e1poje. D\u00edt\u011bti je tedy zaru\u010deno p\u0159i sp\u00e1nku maxim\u00e1ln\u00ed pohodl\u00ed a komfort. KOUPIT JE M\u016e\u017dETE ZDE\u00a0<\/a><\/p>\n<\/div>\n<\/div>\n

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CHR\u00c1NI\u010cE MATRAC\u00cd JSOU skv\u011bl\u00fdm pomocn\u00edkem i p\u0159i tr\u00e9ninku na span\u00ed bez pl\u00ednky. Neusp\u011bchejte ale nic, ka\u017ed\u00e9 d\u00edt\u011b je jin\u00e9. Rozhodn\u011b nikdy d\u00edt\u011b nek\u00e1rejte!<\/em><\/h4>\n

Zaj\u00edm\u00e1 v\u00e1s v\u00edce informac\u00ed? Najdete je ZDE<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Pro\u010d se d\u00edt\u011b v noci po\u010d\u016fr\u00e1v\u00e1, kdy\u017e jeho vrstevn\u00edci u\u017e d\u00e1vno sp\u00ed bez plenek? D\u016fvod\u016f je cel\u00e1 \u0159ada. Opo\u017ed\u011bn\u00fd v\u00fdvoj i genetick\u00e9 dispozice. Mnoho rodi\u010d\u016f se pt\u00e1, pro\u010d se jejich d\u00edt\u011b st\u00e1le po\u010d\u016fr\u00e1v\u00e1. D\u016fvod\u016f je v\u00edce a s pravou p\u0159\u00ed\u010dinou by m\u011bl poradit hlavn\u011b l\u00e9ka\u0159. Poj\u010fme si ale shrnout z\u00e1kladn\u00ed informace. Co je no\u010dn\u00ed pomo\u010dov\u00e1n\u00ed? […]<\/p>\n","protected":false},"author":4,"featured_media":1097,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[72,22],"tags":[463,461,462,460],"yoast_head":"\nNo\u010dn\u00ed pomo\u010dov\u00e1n\u00ed - kdy \u0159e\u0161it a jak\u00e9 jsou p\u0159\u00ed\u010diny? - Learning Toys<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/learningtoys.cz\/blog\/nocni-pomocovani-kdy-resit-a-jake-jsou-priciny\/\" \/>\n<meta property=\"og:locale\" content=\"cs_CZ\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"No\u010dn\u00ed pomo\u010dov\u00e1n\u00ed - kdy \u0159e\u0161it a jak\u00e9 jsou p\u0159\u00ed\u010diny? - Learning Toys\" \/>\n<meta property=\"og:description\" content=\"Pro\u010d se d\u00edt\u011b v noci po\u010d\u016fr\u00e1v\u00e1, kdy\u017e jeho vrstevn\u00edci u\u017e d\u00e1vno sp\u00ed bez plenek? D\u016fvod\u016f je cel\u00e1 \u0159ada. Opo\u017ed\u011bn\u00fd v\u00fdvoj i genetick\u00e9 dispozice. Mnoho rodi\u010d\u016f se pt\u00e1, pro\u010d se jejich d\u00edt\u011b st\u00e1le po\u010d\u016fr\u00e1v\u00e1. D\u016fvod\u016f je v\u00edce a s pravou p\u0159\u00ed\u010dinou by m\u011bl poradit hlavn\u011b l\u00e9ka\u0159. Poj\u010fme si ale shrnout z\u00e1kladn\u00ed informace. Co je no\u010dn\u00ed pomo\u010dov\u00e1n\u00ed? 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