Lang E K, Gershanik J B
South Med J. 1978 Aug;71(8):888-91. doi: 10.1097/00007611-197808000-00005.
A protocolled diagnostic approach for assessing various cystic and solid masses occurring in the neonate and infant, with particular emphasis on renal masses, is described. This protocol uses diagnostic examinations in such a sequence as to establish the diagnosis with acceptable confidence by the least invasive procedure and, therefore, at minimal cost in time, money, and risk to the patient. Early definitive diagnosis permits triage of patients into a group benefiting from immediate surgical intervention versus those with entities that can safely be followed up expectantly. Moreover, certain diagnostic procedures such as antegrade pyelography can be expanded to serve therapeutic purposes as a temporizing percutaneous nephrostomy, thus preserving renal parenchyma and hopefully improving the general condition of the neonate until a definitive surgical procedure can be safely undertaken to correct the underlying deficit.
本文描述了一种用于评估新生儿和婴儿出现的各种囊性和实性肿块的标准化诊断方法，尤其侧重于肾肿块。该方案采用的诊断检查顺序是，通过侵入性最小的程序以可接受的置信度确立诊断，从而在时间、金钱和对患者的风险方面成本最低。早期明确诊断有助于将患者分类为受益于立即手术干预的组和可安全进行期待性随访的实体组。此外，某些诊断程序，如顺行肾盂造影，可以扩展为具有治疗目的的临时经皮肾造瘘术，从而保留肾实质，并有望改善新生儿的一般状况，直到可以安全地进行确定性手术来纠正潜在缺陷。
