微创经皮肾穿刺取石术并发液气胸的处理及预防

Treatment and prevention of hydropneumothorax following minimally invasive percutaneous nephrolithotomy

目的：探讨微创经皮肾镜取石术（MPCNL）并发严重液气胸的预防及临床处理方法。方法：回顾性分析2001年2月-2006年4月期间发生的7例MPCNL后出现严重液气胸患者的临床资料。7例患者中，3例为多发性肾结石，4例为鹿角状肾结石。2例接受闭式胸腔引流，2例在B超定位下穿刺抽吸胸腔内液气，1例合并输尿管石街者行输尿管镜取石术并调整输尿管内支架，2例保守观察。结果：所有患者均顺利恢复。结论：MPCNL导致的液气胸经及时处理，可短期内治愈，良好的准备和细致的操作可预防其发生。

Objective：To investigate the treatment and prevention of hydropneumothorax during minimally invasive percutaneous nephrolithotomy（MPCNL）. Methods： From february 2001 to June 2006,7 cases who received MPCNL developed a hydropneumothorax. We reviewed these clinical data retrospectively. Results：Of 7 cases, 2 cases had a closed thoracic drainage,2 case had a suction under B-ultrasonography guidacnce, 1 case combined with a ureteric stone stress received a ureteroscopic lithotripsy and adjustment of Double-J stent and 2 case had a conserve observation, respectively. All cases cured successfully. Conclusions： Hydropneumothorax during MPCNL could be cured after a prompt treatment, and this complication could be avoided under well preparation and careful manipulation.