宫骶韧带悬吊术和阴道骶骨固定术编码探讨  

Investigation on the Coding of Uterosacral Ligament Suspension and Sacrocolpopexy in Pelvic Floor Reconstruction

作　　者：赖祥朋 Lai Xiangpeng(Department of Medical Records,Dalian Central Hospital,Dalian 116032,Liaoning Province,China)

机构地区：[1]大连市中心医院病案室,辽宁省大连市116032

出　　处：《中国病案》2024年第8期16-18,共3页Chinese Medical Record

摘　　要：子宫脱垂及子宫切除后的阴道穹隆脱垂作为盆腔脏器脱垂中常见的类型,其手术治疗方案有很多,主要分为重建手术和封闭手术,其中重建手术的目的是通过对盆底薄弱松弛的支持结构进行重建修复,恢复盆腔脏器解剖结构。根据是否应用移植物网片,又将其分为修复自体韧带顶端悬吊重建手术及应用网片的顶端固定重建手术。通过分析宫骶韧带悬吊术和阴道骶骨固定术的基本原理,探讨这两种术式的手术与操作编码思路、查找方法。宫骶韧带悬吊术和阴道骶骨固定术的编码关键点在于充分理解“术式”和正确分类“部位”;保留子宫的宫骶韧带悬吊术和切除子宫的宫骶韧带悬吊术编码为69.22其他子宫悬吊术,保留子宫的子宫骶骨固定术编码为69.22其他子宫悬吊术,切除子宫的阴道骶骨固定术的编码为70.78用移植物或假体的阴道悬吊和固定术,同时应另编码70.9说明移植物类型。Female mid-pelvic defect(Uterine prolapse and vaginal vault prolapse after hysterectomy)As a common type of pelvic organ prolapse,there are many surgical treatment options,mainly divided into reconstruction surgery and colpocleisis surgery,The purpose of reconstruction surgery is to reconstruct and repair the weak and loose supporting structure of pelvic floor and restore the anatomical structure of pelvic organs.According to whether or not to apply graft mesh,it is divided into suspension reconstruction surgery for repairing the top of autologous ligament,such as Uterosacral ligament suspension and Sacrospinous ligament fixation.and apical fixation and reconstruction procedures using mesh,such as sacrocolpopexy and TVM.In this paper,we select Uterosacral ligament suspension and sacrocolpopexy,which are representative of these two types of reconstruction operations,to sort out the basic principles of these two types of operations,and to explore the coding ideas,search methods of ICD-9-CM-3 for these two types of operations.The key points of coding uterosacral ligament suspension and vaginosacral fixation are to fully understand the"operation method"and correctly classify the"operation area";Hysterosacral ligament suspension with uterus preservation and uterosacral ligament suspension with uterus removal coded 69.22 Other uterine suspension,uterosacral fixation with uterus preservation coded 69.22 Other uterine suspension,vaginosacral fixation with uterus removal coded 70.78 Vaginal suspension and fixation with graft or prosthesis also coded 70.9 Specify type of graft.

关 键 词：盆腔脏器脱垂 盆底重建手术 手术与操作编码 宫骶韧带悬吊术 阴道骶骨固定术 

分 类 号：R197.323[医药卫生—卫生事业管理]