Rohatgi M, Bajpai M, Gupta D K, Gupta A K
Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi.
Indian Pediatr. 1992 Apr;29(4):425-31.
Ultrasound guided percutaneous antegrade pyelography (USPCAP) was performed in 6 cases between 1 month and 8 years age, presenting with obstructive uropathy. The procedure in this age group was characterized by (i) ease of performance without sedation in the neonates and with sedation in older children, and (ii) use of smaller needles and catheters. The procedure enabled delineation of the intimate anatomy of complicated urological abnormalities such as obstructed duplex system, primary megaureters, posterior urethral valves, prune belly syndrome, obstructive hydronephrosis and vesicoureteric reflux. Percutaneous renal puncture may be established rapidly using ultrasonic guidance in severely ill pediatric patients with obstructive uropathy. B-mode ultrasonography has proved to be rapid, accurate and free of radiation hazards, making it applicable to children with little or no sedation. Guided by ultrasound, percutaneous antegrade pyelography should be considered in the few, selected children with obstructive uropathy when the diagnosis is critical for management and difficult with the usual imaging procedures.
对6例年龄在1个月至8岁、患有梗阻性尿路病的患儿进行了超声引导下经皮顺行肾盂造影（USPCAP）。该年龄组的操作特点为：（i）新生儿无需镇静即可轻松完成操作，大龄儿童则需镇静；（ii）使用较细的针和导管。该操作能够清晰显示复杂泌尿系统异常的精细解剖结构，如梗阻性重复肾、原发性巨输尿管、后尿道瓣膜、梅干腹综合征、梗阻性肾积水和膀胱输尿管反流。对于患有梗阻性尿路病的重症儿科患者，在超声引导下可迅速完成经皮肾穿刺。B型超声已被证明快速、准确且无辐射危害，适用于很少或无需镇静的儿童。在超声引导下，对于少数患有梗阻性尿路病且诊断对治疗至关重要但常规成像检查难以确诊的特定患儿，应考虑进行经皮顺行肾盂造影。
