肝小静脉闭塞症与布加综合征的疾病和手术编码探讨  

Discussion on the Disease and Operation Code of Hepatic Veno-occlusive Disease and Budd-Chiari Syndrome

作　　者：鲍吉庆 吴亚 Bao Jiqing;Wu Ya(Department of Medical Records,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu Province,China;不详)

机构地区：[1]江苏省人民医院(南京医科大学第一附属医院)病案室,江苏省南京市210029 [2]南京市第二医院病案室,江苏省南京市210029

出　　处：《中国病案》2022年第4期20-22,共3页Chinese Medical Record

摘　　要：肝小静脉闭塞症是终末肝小叶静脉的内皮细胞损伤导致肝细胞萎缩、弥漫性肝纤维化的一种肝脏血管性疾病,布加综合征是肝静脉和(或)其开口以上的下腔静脉阻塞所导致的临床症候群,两种疾病非常容易混淆,应注意鉴别诊断。肝小静脉闭塞症的疾病编码为K76.5,符合吡咯烷类生物碱所导致的肝小静脉闭塞症的患者(PAs-HSOS)主要诊断编码为摄入其他植物(或植物的某些部分)的毒性效应(T62.2),布加综合征的疾病编码为I82.0。对应的主要手术编码分别为经颈静脉肝内门体分流术TIPS(39.10),腔静脉支架植入术(39.90),腔静脉血管成形术(39.50),血栓切除术(39.79),导管溶栓术(99.10)。结合案例介绍肝小静脉闭塞症和布加综合征疾病和手术编码,进行对应的编码分析,有助于编码员熟悉两种疾病和对应的手术术式,丰富ICD编码知识和临床知识,以提高两种疾病的编码准确率。Hepatic veno-occlusive disease(HVOD) is a kind of hepatic vascular disease,which is caused by endothelial cell damage of terminal hepatic lobular vein,leading to hepatocyte atrophy and diffuse hepatic fibrosis.Budd-Chiari syndrome(BCS) is a clinical syndrome caused by hepatic vein and(or) inferior vena cava obstruction above its opening.The two diseases are very easy to be confused,so we should pay attention to the differential diagnosis.The disease code of Hepatic veno-occlusive disease is K76.5.The main diagnostic code of patients with hepatic veno-occlusive disease caused by pyrrolidine alkaloids(PAs-HSOS) is toxic effect of ingesting other plants(or some parts of plants)(T62.2).The disease code of Budd-Chiari syndrome is I82.0.The corresponding codes were TIPS(39.10),stent implantation(39.90),vena cava angioplasty(39.50),thrombectomy(39.79) and catheter thrombolysis(99.10).Combined with cases,this paper introduces the coding of Hepatic veno-occlusive disease and Budd-Chiari syndrome,and makes corresponding coding analysis,which is helpful for coders to be familiar with the two diseases and corresponding surgical procedures,enrich ICD coding knowledge and clinical knowledge,and improve the coding accuracy of the two diseases.

关 键 词：肝小静脉闭塞症 布加综合征 疾病编码 手术编码 ICD 

分 类 号：R575[医药卫生—消化系统] R197.323[医药卫生—内科学]