肾移植术后并发症ICD编码探讨  

Discussion on ICD Coding of Complications After Renal Transplantation

作　　者：池梼 陈哲 吴涛涛 张晋宁 李洪璇 李有赞 Chi Tao;Chen Zhe;Wu Taotao;Zhang Jinning;Li Hongxuan;Li Youzan(Department of quality Management,first affiliated Hospital of Army military Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院,重庆市400038

出　　处：《中国病案》2025年第1期30-32,共3页Chinese Medical Record

摘　　要：肾移植手术是目前终末期肾病公认的最佳治疗方式,但是术后依然会面临各种并发症的风险。肾移植术后并发症繁杂亦给编码员提出了更高的挑战。术后微小病毒B19、巨细胞病毒和多瘤病毒感染,导致病毒相关性肾病分类于N04.8和B97.6、B25.9、B34.4,术后泌尿道感染导致尿源性脓毒血症分类于N39.0,术后切口感染分类于T81.4;血管并发症中移植肾动脉狭窄分类于I70.1,移植肾内动静脉瘘分类于I77.0,移植肾动脉血栓形成分类于N28.0,移植肾静脉血栓形成分类于I82.3;排斥反应、移植肾功能延迟恢复、移植肾失功能和移植肾破裂分类于T86.1;移植术后糖尿病分类于E89.8;环孢素A药物中毒、他克莫司药物中毒分类于T45.1和Y43.4;移植肾淋巴管囊肿分类于I89.8。编码员必须紧跟学科发展步伐,学习肾移植术后并发症的病因、临床表现、诊疗方案等一系列专业知识,积极与临床医师进行沟通,将临床诊断与ICD编码相结合,提高编码质量。Renal transplant surgery is currently recognized as the best treatment for end-stage renal disease,but there is still a risk of various complications postoperatively.The complex postoperative complications of renal transplantation also present a higher challenge for coders.Complications such as postoperative parvovirus B19,cytomegalovirus,and polyomavirus infections,leading to virus-related kidney disease,are classified as N04.8 and B97.6,B25.9,and B34.4,respectively.Postoperative urinary tract infections leading to urosepsis are classified as N39.0,postoperative wound infections are classified as T81.4;vascular complications such as transplant renal artery stenosis are classified as I70.1,transplant renal arteriovenous fistula is classified as I77.0,transplant renal artery thrombosis is classified as N28.0,and transplant renal vein thrombosis is classified as I82.3;rejection reactions,delayed recovery of transplant renal function,transplant renal failure,and transplant renal rupture are classified as T86.1;post-transplant diabetes is classified as E89.8;cyclosporine A drug poisoning,tacrolimus drug poisoning are classified as T45.1 and Y43.4;transplant renal lymphatic cysts are classified as I89.8.Coders must keep up with the development of the discipline,learn a series of professional knowledge such as the causes,clinical manifestations,diagnosis and treatment plans of complications after renal transplantation,actively communicate with clinicians,combine clinical diagnosis with ICD coding,and improve coding quality.

关 键 词：肾移植 并发症 ICD编码 

分 类 号：R699.2[医药卫生—泌尿科学]