胸主动脉夹层常用术式介绍与编码案例分析  

Introduction of thoracic aortic dissection and analysis of coding cases

作　　者：刘莎 刘骏峰[1] 辛子艺 LIU Sha;LIU Junfeng;XIN Ziyi(The First Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510000,China)

机构地区：[1]中山大学附属第一医院,广东广州510000

出　　处：《现代医院》2022年第6期881-883,共3页Modern Hospitals

基　　金：广东省卫生经济学会面上课题项目(2021-WJMZ-16)。

摘　　要：胸主动脉夹层常用术式可以分为开放手术、介入手术和杂交手术三类。开放性手术主要有:Wheat、David、Bentall、Cabrol、Sun’s手术;介入手术包括主动脉腔内隔绝术、主动脉分支支架术,其中主动脉分支支架术包括原位开窗支架术、预开窗支架术和烟囱支架术等;杂交手术则是腔内隔绝术与动脉旁路术的结合。主动脉根部的解剖结构复杂,胸主动脉夹层病变有时累及主动脉根部如冠状动脉开口,或者合并主动脉瓣的病变等,因此胸主动脉夹层的手术方术也复杂多样。编码过程中需要掌握胸主动脉夹层的部位、范围等疾病特征,通读手术记录挖掘关键信息提炼手术名称,依据夹层手术的特点对手术记录中所有手术一一编码,只有透彻地掌握胸主动脉夹层各种术式的内涵,方能正确完整地编码。Thoracic aortic dissection can be divided into open surgery,interventional surgery and hybrid surgery.Open surgeries include Wheat,David,Bentall,Cabrol,Sun’s surgery;Interventional surgery includes intracavascular aortic isolation and aortic branch stenting,among which aortic branch stenting includes in-situ fenestration stenting,prefenestration stenting and chimney stenting.Hybrid surgery is a combination of endovascular isolation and arterial bypass.The anatomical structure of the aortic root is complex,and the thoracic aortic dissection sometimes involves the aortic root,such as the coronary artery opening,or the lesions associated with the aortic valve,etc.Therefore,the surgical procedures for thoracic aortic dissection are also complex and varied.In the process of coding,it is necessary to master the location and scope of thoracic aortic dissection and other disease characteristics,read through the surgical records,mine the key information and extract the surgical name,and code all surgeries in the surgical records according to the characteristics of the dissection surgery.Only by thoroughly mastering the connotation of thoracic aortic dissection can we correctly and completely code it.

关 键 词：胸主动脉夹层 手术编码 ICD-9-CM-3 

分 类 号：R543.1[医药卫生—心血管疾病]