二尖瓣瓣周漏的手术类型及编码要点  

Surgical Types and Coding Points of Mitral Paravalvular Leak

作　　者：刘思琦 赖丽文[1] 陈丽[1] 赵淑媛[1] Liu Siqi;Lai Liwen;Chen Li;Zhao Shuyuan(Department of Medical Records, Guangdong Academy of Medical Science, Guangdong General Provincial people＇s Hospital, Guangzhou 510080, Guangdong Provience, China)

机构地区：[1]广东省医学科学院广东省人民医院病案科,广州市510080

出　　处：《中国病案》2018年第4期27-30,共4页Chinese Medical Record

摘　　要：二尖瓣瓣周漏是二尖瓣置换术的严重术后并发症。近年来治疗二尖瓣瓣周漏的手术方式不断地在改良与创新。不同的手术方式以及手术材料,是影响此类手术编码的重要因素。本文介绍当前治疗二尖瓣瓣周漏的几种主要手术类型,分别是开放式手术(直视下二尖瓣瓣瓣周漏修补术、传统开胸二尖瓣瓣膜再次置换术)、胸腔镜下手术(胸腔镜下二尖瓣瓣周漏修补术、胸腔镜二尖瓣瓣膜再次置换术)、介入手术(不同体表血管入路的二尖瓣瓣周漏封堵)、镶嵌(杂交)手术(胸腔内不同位置入路的二尖瓣瓣周漏封堵)。通过实例分析,认识此类手术的实际操作过程,总结ICD编码思路,同时也提出适当扩展手术编目的必要性。Mitralparavalvular leak（MPVL） is a serious postoperative complication of Mitral valve replacement（MVR）, which is a common cardiac surgery. In recent years, the operative ways for MPVL have continuously been improved and innovated. Different surgical methods and materials are important factors affecting the coding of this kind of operation. The main operative types of MPVL was introduced in this article,including open surgery（Direct optic mitral valve circumferential fistula repair, traditional open MVR）,thoracoscopic surgery（VATS mitral valve circumferential leakage repair, thoracoscopic MVR）, interventional surgery（mitral valve circumferential leakage closure with different body surface vascular access） and hybrids surgery（mitral valve circumferential leakage closure with different position approach in the thoracic cavity）. By analysing clinical cases and understanding the whole process of this type of surgery, we summerized the encoding methods and put forword the necessity of extending the cataloging of the operation.

关 键 词：二尖瓣瓣周漏 手术类型 手术编码 

分 类 号：R197.323[医药卫生—卫生事业管理]