自发性脑出血ICD-10与ICD-11编码对比分析  

Comparative analysis of ICD-10 and ICD-11 coding for spontaneous cerebral hemorrhage

作　　者：石文洁 王晓燕 张元 杨德武 SHI Wenjie;WANG Xiaoyan;ZHANG Yuan;YANG Dewu(Beijing Health Vocational College,Beijing 102402,China)

机构地区：[1]北京卫生职业学院,北京102402

出　　处：《现代医院》2023年第7期1033-1036,共4页Modern Hospitals

摘　　要：目的本文结合自发脑出血的临床诊疗指南,对比其在现行的ICD-10与ICD-11中的编码差异,以期为ICD-11的推广使用和分类发展提供参考。方法参照ICD-11分类调整的国内外研究进展,从分类结构、编码结构和编码规则等不同的维度对ICD-10和ICD-11进行比较剖析。结果ICD-11中自发性脑出血由循环系统分类调整至神经系统。以脑内出血为例,ICD-11除疾病本身主干码外,以另编码形式补充说明目前临床广泛应用的脑出血SMASH-U病因分型,同时以扩展码的形式增加细节(即GCS量表结果以评估患者病情严重程度)。结论ICD-11通过后组配的组合式编码形成的簇编码,对疾病的表达更加精细化,更适应现代医学的发展和医院管理需求。Objective To promote the application and classification development of ICD-11(the International Statistical Classification of Diseases and Related Health Problems 11th Revision)through comparison of the coding differences between ICD-10 and ICD-11,while in combination with the guidelines for clinical diagnosis and treatment of spontaneous cerebral hemorrhage.Methods Through reviewing global research progress of ICD-11 classification adjustment,ICD-10 and ICD-11 were compared and analyzed from various dimensions such as classification structure,coding structure,coding rules and so on.Results Spontaneous cerebral hemorrhage was re-classified from circulation system disease to neurological diseases in ICD-11.Taking intracerebral hemorrhage as an example,in addition to being written to the trunk code,ICD-11 further encoded the most widely used SMASH-U etiologic classification in clinic for cerebral hemorrhage,and meanwhile,extended the results of the GCS scale in extra coding nodes to assess the illness severity of the patient.Conclusion ICD-11 is more refined in disease classification through the cluster code formed by the combination of post-combination coding than ICD-10.It fits better to the development of modern medicine and well meets the needs of hospital management.

关 键 词：自发性脑出血 ICD-11 ICD-10 

分 类 号：R197[医药卫生—卫生事业管理]