{"id":9363,"date":"2015-07-28T12:01:24","date_gmt":"2015-07-28T09:01:24","guid":{"rendered":"https:\/\/yenirehberlik.com\/?p=9363"},"modified":"2015-07-27T12:10:39","modified_gmt":"2015-07-27T09:10:39","slug":"cocuklarin-gece-alt-islatmasi-ve-tedavi-yollari","status":"publish","type":"post","link":"https:\/\/yenirehberlik.com\/arsiv\/cocuklarin-gece-alt-islatmasi-ve-tedavi-yollari.html","title":{"rendered":"\u00c7ocuklar\u0131n Gece Alt Islatmas\u0131 ve Tedavi Yollar\u0131"},"content":{"rendered":"

EN\u00dcREZ\u0130S NOKTURNA<\/strong>
\n\u0130stem d\u0131\u015f\u0131 olan idrar \u00e7\u0131k\u0131\u015f\u0131na en\u00fcrezis denmektedir. Bu durum daha \u00e7ok gece uyku esnas\u0131nda olu\u015ftu\u011fundan en\u00fcrezis nokturna ad\u0131n\u0131 almaktad\u0131r. Ancak bu durumdaki \u00e7ocuklarda te\u015fhisin konulabilmesi i\u00e7in gereken ya\u015f alt s\u0131n\u0131r\u0131 5 (be\u015f)’tir. Be\u015f (5) ya\u015f\u0131n\u0131 doldurmam\u0131\u015f bir \u00e7ocu\u011fun gece idrar ka\u00e7\u0131rmas\u0131 ise do\u011fal olarak kabul edilmektedir ve 5 ya\u015f\u0131n\u0131 doldurana kadar da tedavi \u00f6nerilmemektedir.<\/p>\n

Yap\u0131lan ara\u015ft\u0131rmalara g\u00f6re 5 ya\u015f\u0131ndaki erkek \u00e7ocuklarda gece i\u015femelerinin s\u0131kl\u0131\u011f\u0131 % 7; k\u0131zlarda ayn\u0131 ya\u015fta % 3 olarak saptanm\u0131\u015ft\u0131r. Bu oranlar 10 ya\u015f\u0131nda erkeklerde % 3\u2019e; k\u0131zlarda % 2\u2019ye d\u00fc\u015fmektedir. 18 ya\u015f\u0131na gelen erkeklerde % 1, k\u0131zlarda ise biraz daha d\u00fc\u015f\u00fck bir y\u00fczdede s\u00fcrebilmektedir. Bu \u00e7ocuklarda ya\u015f\u0131tlar\u0131na g\u00f6re geli\u015fimsel gecikmeler de saptanm\u0131\u015ft\u0131r. 5 ya\u015f sonras\u0131nda tedavisiz kendili\u011finden iyile\u015fme oran\u0131 % 5-10 aras\u0131nda bulunmu\u015ftur.<\/p>\n

Rahats\u0131zl\u0131\u011f\u0131n te\u015fhisi i\u00e7in en az 3 ay s\u00fcre ile haftada en az 2 kez idrar ka\u00e7\u0131rman\u0131n olmas\u0131 ya da toplumsal, mesleki i\u015flevsellikte, okul ba\u015far\u0131s\u0131nda d\u00fc\u015fmeye ve sorunlara yol a\u00e7mas\u0131 , ki\u015finin 5 ya\u015f\u0131ndan b\u00fcy\u00fck olmas\u0131 gerekmektedir. Ayr\u0131ca idrar ka\u00e7\u0131rma durumu ba\u015fka bir ilac\u0131n yan etkisine ba\u011fl\u0131 olmamal\u0131, ki\u015fide idrar ka\u00e7\u0131rmaya sebep olabilecek bir hastal\u0131k olmad\u0131\u011f\u0131 tespit edilmelidir (\u015feker hastal\u0131\u011f\u0131, \u00fcrolojik ya da n\u00f6rolojik hastal\u0131klar gibi).
\nEn\u00fcrezis riskini artt\u0131ran durumlar:<\/strong><\/p>\n

-Yo\u011fun psikososyal sorunlar i\u00e7inde olan ve olumsuz \u00e7evresel ko\u015fullarda ya\u015fayan \u00e7ocuklar<\/p>\n

-Baba ya da annenin bo\u015fanma ya da \u00f6l\u00fcm sonucu kayb\u0131 da \u00f6nemli etkenlerdendir. \u00d6zellikle daha \u00f6ncesinde idrar kontrol\u00fcn\u00fcn sa\u011fland\u0131\u011f\u0131 \u00e7ocuklarda sonradan 5-8 ya\u015flar\u0131 aras\u0131nda idrar ka\u00e7\u0131rma bu nedenle tekrar ba\u015flayabilmektedir.<\/p>\n

-Yeni bir karde\u015fin do\u011fmas\u0131.
\n-Davran\u0131\u015fsal bozukluklar g\u00f6steren \u00e7ocuklarda mesane kapasitesinin daha s\u0131n\u0131rl\u0131 oldu\u011fu ve bu durumun daha s\u0131k g\u00f6zlendi\u011fi saptanm\u0131\u015ft\u0131r.<\/p>\n

-Yap\u0131lan \u00e7al\u0131\u015fmalara g\u00f6re ailede anne, baba ve di\u011fer akrabalar\u0131n ge\u00e7mi\u015f ya\u015fant\u0131lar\u0131nda bu sorun var ise, \u00e7ocuklarda da en\u00fcrezis riski 5-7 kat artmaktad\u0131r.<\/p>\n

\u00c7ocukta gece i\u015femeleri varl\u0131\u011f\u0131nda yap\u0131lmas\u0131 gereken incelemeler:<\/p>\n

\u00d6ncelikle idrar yollar\u0131nda mikrobik bir durum varl\u0131\u011f\u0131, basit bir idrar tahlili ile ara\u015ft\u0131r\u0131labilir. Bu duruma idrar yollar\u0131n\u0131n \u00f6zelli\u011fi nedeniyle daha \u00e7ok k\u0131z \u00e7ocuklar\u0131nda rastlanmaktad\u0131r. Daha nadiren rastlansa da idrar yollar\u0131ndaki yap\u0131sal kusurlar varl\u0131\u011f\u0131 radyolojik incelemeler ile belirlenebilir. N\u00f6rolojik muayene ve \u015feker hastal\u0131\u011f\u0131 varl\u0131\u011f\u0131 a\u00e7\u0131s\u0131ndan kan \u015feker d\u00fczeyi ara\u015ft\u0131r\u0131lmal\u0131d\u0131r.
\n\u00c7ocuklarda veya nadiren ergenlik ve erken eri\u015fkinlik d\u00f6nemlerinde g\u00f6r\u00fclen gece i\u015femesinin tespit edilebilir ba\u015fka bir nedeni yok ise; neden uykunun a\u015f\u0131r\u0131 a\u011f\u0131r olmas\u0131d\u0131r. Bu durumda idrar\u0131n yeterince mesanede tutulmas\u0131na olanak veren \u201cfark\u0131ndal\u0131k\u201d d\u00fczeyi uykusu a\u011f\u0131r olanlarda bulunmaz. Ki\u015fi gece uyurken idrar\u0131n\u0131n geldi\u011finin fark\u0131na varmadan, idrar\u0131n\u0131 ka\u00e7\u0131r\u0131r. Gece idrar ka\u00e7\u0131rmas\u0131 olmayanlar ise idrarlar\u0131 geldi\u011finde sabaha kadar tutabilirler, veya hemen idrarlar\u0131n\u0131 yapmak i\u00e7in tuvalete gidebilirler.
\nBurada, a\u011f\u0131r uyku durumunda, mesanenin (idrar kesesinin) \u00e7\u0131k\u0131\u015f\u0131ndaki idrar\u0131 tutan kas yeterince \u00e7al\u0131\u015fmad\u0131\u011f\u0131ndan, idrar tutulamaz ve idrar ka\u00e7\u0131r\u0131l\u0131r. Tedavideki ama\u00e7 gece uykusunun a\u011f\u0131rl\u0131\u011f\u0131n\u0131 yani derinli\u011fini hafifletmektir.
\nA\u011f\u0131r uykusu olanlarda ayn\u0131 zamanda da dikkat eksikli\u011fi problemleri s\u0131kl\u0131kla da e\u015flik eder. Uykunun hafiflemesi yine dikkat bozuklu\u011funu d\u00fczeltir.<\/p>\n

Tedavi<\/strong>:<\/p>\n

Yukar\u0131da da belirtildi\u011fi gibi, tedavide ama\u00e7 a\u011f\u0131r olan uykunun hafifletilmesidir. Uyku s\u00fcresi ayn\u0131 kalabilir.
\n\u0130la\u00e7 tedavisi yan\u0131nda uygulanabilen psikoterapi, \u00f6zellikle davran\u0131\u015fsal sorunlar ya\u015fayanlarda etkili olmaktad\u0131r. Bu \u00f6zellikle sonradan ba\u015flayan idrar ka\u00e7\u0131rmalar\u0131nda gereklidir.
\nTedavi etmeyen ancak daha \u00e7ok da \u00fcrologlar taraf\u0131ndan \u00f6nerilen di\u011fer bir y\u00f6ntem ise, \u0131slanmaya duyarl\u0131 nesnelerle d\u00f6\u015fenmi\u015f olan \u00f6zel donan\u0131ml\u0131 bir yata\u011f\u0131n , \u0131slanma ile ikaz edici bir ses \u00e7\u0131karmas\u0131na ve ki\u015finin bu durumu zaman i\u00e7inde \u00f6\u011frenebilmesine dayanan bir sistemdir. Asl\u0131nda ‘kap\u0131 zili’nin bir \u015feklidir. Yani sadece uyand\u0131rmak i\u00e7in bir zil sisteminin kurulmas\u0131d\u0131r.
\nIrsi (genetik) olsa dahi tedavi gerektirecek bir rahats\u0131zl\u0131k oldu\u011fundan zaman kaybedilmemelidir. Aile veya \u00e7evre belli ya\u015fta ge\u00e7ece\u011fini s\u00f6ylese\/d\u00fc\u015f\u00fcnse de tam olarak d\u00fczelece\u011fi yani idrar ka\u00e7\u0131rman\u0131n bitece\u011fi ya\u015f konusunda kesin bir zaman s\u00f6ylenemez. Ailesel olanlarda belli bir ya\u015fta ge\u00e7ti\u011fi g\u00f6r\u00fcl\u00fcyor olsa da o anki sorunu ya\u015fayan \u00e7ocuk i\u00e7in yine de bitebilece\u011fi ya\u015f konusunda zaman s\u00f6ylenemez.
\nSosyal hayatta sorun ya\u015fatan gece idrar ka\u00e7\u0131rma asl\u0131nda \u00e7ocu\u011fun ve ailenin belli bir yerde gece konaklama\/misafirli\u011fi zorla\u015fmaktad\u0131r. S\u00fcrekli alt\u0131n\u0131 \u0131slataca\u011f\u0131n\u0131 d\u00fc\u015f\u00fcnen \u00e7ocuk gitmek istemezken anne de gidilen yerde s\u00fcrekli endi\u015fe duyar. B\u00f6ylece gece yat\u0131l\u0131 olarak bir yere gidilmemeye ba\u015flan\u0131r.
\nYap\u0131lan bir hata da alt bezinin ba\u011flanarak idrar\u0131n yata\u011fa ge\u00e7mesinin \u00f6nlenme \u00e7abas\u0131d\u0131r. Bu da \u00e7ocukta g\u00fcveni art\u0131raca\u011f\u0131 i\u00e7in idrar ka\u00e7\u0131rma konusunda ve yata\u011f\u0131 \u0131slatma endi\u015fesini\u015fn kalkmas\u0131 nedeniyle idrar ka\u00e7\u0131rma konusunda pek de yard\u0131mc\u0131 olmaz. Alt bezi ba\u011flanmas\u0131n\u0131 \u00f6nermiyoruz.<\/strong>
\nGece yatmadan \u00f6nce idrar ka\u00e7\u0131rmas\u0131n diye \u00e7ocuklara s\u0131v\u0131 i\u00e7irilmemesi \u00f6nerilse de s\u0131kl\u0131kla bu \u00e7ocuklarda sanki bir inat\/tepki varm\u0131\u015f gibi s\u0131v\u0131 i\u00e7eceklerin t\u00fcketilmesi artmaktad\u0131r. T\u00fcketmemesi s\u00f6ylendik\u00e7e daha fazla t\u00fcketilir. Zaten idrar ka\u00e7\u0131rman\u0131n as\u0131l sebebi fazla s\u0131v\u0131 al\u0131nmas\u0131 da de\u011fildir. Sadece biraz daha fazla art\u0131ran risk olabilir.<\/p>\n

Kaynak:\u00a0Dr.Murat Eren \u00d6ZEN, Ruh Sa\u011fl\u0131\u011f\u0131 ve Hastal\u0131klar\u0131 Uzman\u0131 (Psikiyatr)\u00a0www.stres112.com.<\/p>\n","protected":false},"excerpt":{"rendered":"

EN\u00dcREZ\u0130S NOKTURNA \u0130stem d\u0131\u015f\u0131 olan idrar \u00e7\u0131k\u0131\u015f\u0131na en\u00fcrezis denmektedir. Bu durum daha \u00e7ok gece uyku esnas\u0131nda olu\u015ftu\u011fundan en\u00fcrezis nokturna ad\u0131n\u0131 almaktad\u0131r. Ancak bu durumdaki \u00e7ocuklarda te\u015fhisin konulabilmesi i\u00e7in gereken ya\u015f alt s\u0131n\u0131r\u0131 5 (be\u015f)’tir. Be\u015f (5) ya\u015f\u0131n\u0131 doldurmam\u0131\u015f bir \u00e7ocu\u011fun gece idrar ka\u00e7\u0131rmas\u0131 ise do\u011fal olarak kabul edilmektedir ve 5 ya\u015f\u0131n\u0131 doldurana kadar da tedavi […]<\/p>\n","protected":false},"author":1,"featured_media":9364,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[648],"tags":[650,80],"class_list":["post-9363","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cocuk-psikolojisi","tag-alt-islatma","tag-cocuk"],"yoast_head":"\n\u00c7ocuklar\u0131n Gece Alt Islatmas\u0131 ve Tedavi Yollar\u0131 -<\/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:\/\/yenirehberlik.com\/arsiv\/cocuklarin-gece-alt-islatmasi-ve-tedavi-yollari.html\" \/>\n<meta property=\"og:locale\" content=\"tr_TR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u00c7ocuklar\u0131n Gece Alt Islatmas\u0131 ve Tedavi Yollar\u0131 -\" \/>\n<meta property=\"og:description\" content=\"EN\u00dcREZ\u0130S NOKTURNA \u0130stem d\u0131\u015f\u0131 olan idrar \u00e7\u0131k\u0131\u015f\u0131na en\u00fcrezis denmektedir. Bu durum daha \u00e7ok gece uyku esnas\u0131nda olu\u015ftu\u011fundan en\u00fcrezis nokturna ad\u0131n\u0131 almaktad\u0131r. Ancak bu durumdaki \u00e7ocuklarda te\u015fhisin konulabilmesi i\u00e7in gereken ya\u015f alt s\u0131n\u0131r\u0131 5 (be\u015f)’tir. 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Be\u015f (5) ya\u015f\u0131n\u0131 doldurmam\u0131\u015f bir \u00e7ocu\u011fun gece idrar ka\u00e7\u0131rmas\u0131 ise do\u011fal olarak kabul edilmektedir ve 5 ya\u015f\u0131n\u0131 doldurana kadar da tedavi […]","og_url":"https:\/\/yenirehberlik.com\/arsiv\/cocuklarin-gece-alt-islatmasi-ve-tedavi-yollari.html","article_published_time":"2015-07-28T09:01:24+00:00","author":"yenirehberlik","twitter_card":"summary_large_image","twitter_misc":{"Yazan:":"yenirehberlik","Tahmini okuma s\u00fcresi":"5 dakika"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/yenirehberlik.com\/arsiv\/cocuklarin-gece-alt-islatmasi-ve-tedavi-yollari.html#article","isPartOf":{"@id":"https:\/\/yenirehberlik.com\/arsiv\/cocuklarin-gece-alt-islatmasi-ve-tedavi-yollari.html"},"author":{"name":"yenirehberlik","@id":"https:\/\/yenirehberlik.com\/arsiv\/#\/schema\/person\/8bd9eb0409887ea38d367fb33bf897af"},"headline":"\u00c7ocuklar\u0131n Gece Alt Islatmas\u0131 ve Tedavi 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