抗结核药物有害效应诊断编码及其外因编码探讨  

Discussion on Diagnostic and External Cause Coding for Adverse Effects of Anti-tuberculous Drugs

作　　者：纪德胜 任妮丽 彭城 黄颖 Ji Desheng;Ren Nili;Peng Cheng;Huang Ying(Department of medical records&statistics,Wuhan Pulmonary Hospital,Wuhan 430030,Hubei Province,China;不详)

机构地区：[1]武汉市肺科医院病案统计科,湖北省武汉市430030

出　　处：《中国病案》2024年第11期24-27,共4页Chinese Medical Record

基　　金：武汉市医学科研项目(WG21A04)。

摘　　要：抗结核药物种类繁多,多存在有害效应。常见有害效应有神经系统反应、肝功能损害、胃肠道反应、血液循环系统障碍、心功能异常、肌肉骨骼系统反应、皮疹和听力、视力下降等。在ICD-10中,抗结核药物有害效应外因编码多以药物名称作为主导词进行查询,若药物名称无法直接查询,则以药物类别,即抗分枝杆菌药或抗生素作为主导词进行查询。对于多种抗结核药物同时作用导致的有害效应,若多种药物均为同一类别药物,则以药物类别作为主导词进行查询;若是异烟肼和利福平导致的有害效应,则编码于Y40.6利福霉素类的有害效应;若是其他抗分枝杆菌药和全身性抗生素导致的有害效应,则需要对抗分枝杆菌药和全身性抗生素的有害效应外因分别编码。在编码实践中应注意区分有害效应与中毒的概念差异,明确中毒的类型。在实际工作中编码员应加强病案内容阅读,积极与临床医师沟通,准确填写抗结核药物有害效应及其外因编码。There are various types of anti-tuberculosis drugs,many of which have harmful effects.Common harmful effects include neurological reactions,liver function damage,gastrointestinal reactions,circulatory disorders,cardiac dysfunction,musculoskeletal system reactions,rash and hearing loss,and decreased vision.In ICD-10,the codes for the external causes of adverse effects of anti-tuberculosis drugs are mostly queried using the drug name as the leading word.If the drug name cannot be directly queried,the drug category,namely anti mycobacterial drugs or antibiotics,is used as the leading word for querying.For the harmful effects caused by the simultaneous use of multiple anti-tuberculosis drugs,if the multiple drugs are of the same category,the drug category is used as the leading word for the search;If the harmful effects caused by isoniazid and rifampicin are encoded as"Y40.6 harmful effects of rifampicin class";If the harmful effects are caused by other anti-mycobacterial drugs and systemic antibiotics,it is necessary to code the external factors of the harmful effects of anti-mycobacterial drugs and systemic antibiotics separately.In coding practice,attention should be paid to distinguishing the conceptual differences between harmful effects and poisoning and clarifying the types of poisoning.In practical work,it is necessary to strengthen the reading of medical records,actively communicate with clinical physicians,and accurately fill in the harmful effects of anti-tuberculosis drugs and their external cause codes.

关 键 词：抗结核药物 有害效应 损伤中毒外因 

分 类 号：R978.3[医药卫生—药品]