基于ICD-10和国家临床版疾病库的耐多药结核病编码探讨

Multidrug-resistant Tuberculosis Based on ICD-10 and National Clinical Disease Library

耐多药结核病死亡率高(16%),治愈率低(54%),医疗资源消耗高,其发病率有逐年增高的趋势,且具有严重的公共危害性。在耐多药结核病的编码中,根据发病部位分为肺和支气管的耐多药结核、肺和支气管外的耐多药结核以及广泛耐药结核。肺和支气管的耐多药结核编码采用国家临床版疾病库中A15.000的扩展码;肺和支气管外的耐多药结核采用A17~A18类目说明结核的部位,采用ICD-10第22章中对抗菌药物产生耐药性的菌株(U80-U89)类目辅助编码说明其耐药性;广泛耐药结核在耐多药结核的编码基础上采用ICD-10第22章中对抗菌药物产生耐药性的菌株(U80-U89)类目辅助编码说明其他的耐药菌株。建议完善ICD-10和国家临床版疾病库,使其更符合临床和编码需求。

Multi-drug-resistant tuberculosis has a high mortality rate(16%),a low cure rate(54%),high medical resource consumption,and its incidence rate is increasing year by year,and it has serious public hazards.In the application code for multidrug-resistant tuberculosis,pulmonary and bronchial multidrug-resistant tuberculosis,multidrug-resistant tuberculosis outside the lungs and XDR-TB are classified according to the site of the disease.The code of pulmonary and bronchial multidrug-resistant tuberculosis uses the A15.000 extension code in the National Clinical disease library.The code of multidrug-resistant tuberculosis outside the lungs and bronchi uses the A17-A18 category to describe the site of tuberculosis,using the antibiotic-resistant strain(U80-U89)category-assisted coding in Chapter 22 of ICD-10 Assistance coding;XDR-TB uses antibiotic-resistant strains(U80-U89) in Chapter 22 of ICD-10 to illustrate other drug-resistant strains based on the coding of multidrug-resistant tuberculosis.It is recommended to improve the ICD-10 and national clinical disease libraries to better meet clinical and coding needs.