Barnacle Alex M, Roebuck Derek J, Racadio John M
Department of Radiology, Great Ormond Street Hospital, London, UK.
Tech Vasc Interv Radiol. 2010 Dec;13(4):229-37. doi: 10.1053/j.tvir.2010.04.005.
Nephro-urological interventions developed in adult practice are highly transferable to the pediatric setting, and their use has widened the role of interventional radiology in the management of renal tract pathology in spheres such as oncology and urolithiasis. The emerging evidence is that these procedures are safe and effective in children and their use should be encouraged. Many of the techniques are similar to those used in adults. There are, however, subtle but important pediatric tips and tricks available that serve to minimize risk to the child and increase the chances of technical success. This article covers the indications, techniques, aftercare, and complications for renal biopsy, nephrostomy insertion, percutaneous nephrolithomy procedures, and ureteric stent insertion. Renal biopsy and nephrostomy insertion are commonly performed in most pediatric centers. Percutaneous nephrolithomy may be limited to centers with a significant urology workload, but are complex procedures ideally performed as joint cases between urology and interventional radiology.
成人医学实践中发展起来的肾泌尿系统介入技术很容易应用于儿科领域，其应用扩大了介入放射学在肿瘤学和尿路结石症等领域对肾道疾病的管理作用。新出现的证据表明，这些手术在儿童中是安全有效的，应鼓励使用。许多技术与成人使用的技术相似。然而，有一些细微但重要的儿科技巧，可以将对儿童的风险降至最低，并增加技术成功的机会。本文涵盖了肾活检、肾造瘘术、经皮肾镜取石术和输尿管支架置入术的适应症、技术、术后护理及并发症。大多数儿科中心都常规进行肾活检和肾造瘘术。经皮肾镜取石术可能仅限于泌尿外科工作量较大的中心，但这些都是复杂的手术，理想情况下应作为泌尿外科和介入放射科的联合病例进行操作。
