单病种经皮动脉导管未闭封堵术临床路径费用明细表1（按阶段）

单病种病态窦房结综合征单腔永久起搏器植入临床路径费用明细表1（按阶段）,,,,,,,

类别,项目名称,规格,数量（最小）,数量（最大）,单价/元,总价/元（min）,总价/元（max）

一、入院及术前准备,,,,,,,

1.入院检查,,,,,,,

血细胞分析+超敏C+血型鉴定,C—反应蛋白测定(CRP),项,1,1,8.40,8.40,8.40

,超敏C反应蛋白测定（免疫荧光法）,次,1,1,45.00,45.00,45.00

,全血细胞计数+五分类,套,1,1,25.00,25.00,25.00

,网织红细胞计数(Ret)(仪器法),项,1,1,6.00,6.00,6.00

,Rh血型鉴定/次（必要时）,次,0,1,11.00,0.00,11.00

,ABO红细胞定型/次,次,1,1,3.60,3.60,3.60

凝血五项+FDP,活化部分凝血活酶时间测定(APTT)(仪器法)/,项,1,2,15.00,15.00,30.00

,凝血酶时间测定(TT)(仪器法)/项,项,1,2,20.00,20.00,40.00

,纤维蛋白(原)降解产物测定(FDP)(仪器法)/项,项,1,2,45.00,45.00,90.00

,血浆D-二聚体测定(D-Dimer)(各种免疫学方法)/项,项,1,2,80.00,80.00,160.00

,血浆凝血酶原时间测定(PT)(仪器法)/项,项,1,2,15.00,15.00,30.00

,血浆纤维蛋白原测定(仪器法)/项,项,1,2,20.00,20.00,40.00

肾功能,肌酐测定/项,项,1,1,7.10,7.10,7.10

,内生肌酐清除率试验/项,项,1,1,8.00,8.00,8.00

,尿素测定/项,项,1,1,7.00,7.00,7.00

,血清尿酸测定/项,项,1,1,7.20,7.20,7.20

,血清碳酸氢盐(HCO3)测定/项,项,1,1,9.20,9.20,9.20

,血清胱抑素(CystatinC)测定/项,项,1,1,15.00,15.00,15.00

电解质,钾测定/项,项,1,1,5.00,5.00,5.00

,钙测定/项,项,1,1,5.00,5.00,5.00

,氯测定/项,项,1,1,5.00,5.00,5.00

,钠测定/项,项,1,1,5.00,5.00,5.00

血气分析,全血乳酸测定/项,项,1,8,12.30,12.30,98.40

,血气分析/次,次,1,8,42.00,42.00,336.00

微量血糖测定,葡萄糖测定(干化学法)/次,次,1,7,15.00,15.00,105.00

免疫三项,丙型肝炎抗体测定(Anti-HCV)/项,项,1,1,21.90,21.90,21.90

,梅毒螺旋体特异抗体测定/项,项,1,1,15.00,15.00,15.00

,人免疫缺陷病毒抗体测定(Anti-HIV)/项,项,1,1,22.80,22.80,22.80

尿常规,尿常规检查/次,次,1,2,3.50,3.50,7.00

,尿液分析/次,次,1,2,8.00,8.00,16.00

肝功能,腺苷脱氨酶测定/项,项,1,1,8.00,8.00,8.00

,血清α-L-岩藻糖苷酶测定/项,项,1,1,7.70,7.70,7.70

,血清γ-谷氨酰基转移酶测定/项,项,1,1,5.00,5.00,5.00

,血清白蛋白测定/项,项,1,1,3.50,3.50,3.50

,血清丙氨酸氨基转移酶测定/项,项,1,1,5.00,5.00,5.00

,血清胆碱脂酶测定/项,项,1,1,8.20,8.20,8.20

,血清间接胆红素测定/项,项,1,1,4.00,4.00,4.00

,血清碱性磷酸酶测定/项,项,1,1,5.00,5.00,5.00

,血清前白蛋白测定/项,项,1,1,9.40,9.40,9.40

,血清天门冬氨酸氨基转移酶测定/项,项,1,1,5.00,5.00,5.00

,血清直接胆红素测定/项,项,1,1,4.00,4.00,4.00

,血清总胆汁酸测定/项,项,1,1,12.00,12.00,12.00

,血清总蛋白测定/项,项,1,1,3.60,3.60,3.60

,血清总胆红素测定/项,项,1,1,4.00,4.00,4.00

,血清总胆固醇测定/项,项,1,1,4.00,4.00,4.00

乙肝表面抗原测定,乙型肝炎表面抗原测定(HBsAg)(定量)/项,项,1,1,15.00,15.00,15.00

大便常规+隐血,粪便常规/次,项,1,1,2.50,2.50,2.50

,粪便隐血试验(OB)(免疫法)/项,项,1,1,6.00,6.00,6.00

,粪寄生虫镜检/次,次,1,1,4.60,4.60,4.60

常规心电图检查(十二通道),常规心电图检查（床旁心电图加收）/次,次,1,1,5.00,5.00,5.00

,常规心电图检查(十二通道)/次,次,1,1,25.00,25.00,25.00

超声心动图,室壁运动分析/次,次,0,1,18.00,0.00,18.00

,心内膜自动边缘检测/次,次,0,1,29.00,0.00,29.00

,心脏彩色多普勒超声/次,次,0,1,85.00,0.00,85.00

,组织多普勒显象(TDI)/次,次,0,1,29.00,0.00,29.00

,左心功能测定/次,次,0,1,45.00,0.00,45.00

,彩色室壁动力(CK)/次,次,0,1,29.00,0.00,29.00

,超声计算机图文报告/次,次,0,1,8.20,0.00,8.20

胸部正侧位片,X线摄影(加滤线器计费)加收/个,个,2,2,1.00,2.00,2.00

,数字化摄影(DR)/次,次,2,2,45.00,90.00,90.00

,X线数字化摄影激光胶片/日本柯尼卡14*17in(新,片,2,2,20.52,41.04,41.04

2.药品、治疗相关项目,氯化钠注射液(0.9%塑料瓶),100ml:0.9g/瓶,0,2,2.80,0.00,5.60

,氯化钠注射液(0.9%塑料安瓿)(H),10ml:0.09g/支,0,2,1.39,0.00,2.78

,注射用头孢唑林钠,0.5g/瓶,0,2,1.80,0.00,3.60

,葡萄糖氯化钠注射液(5%塑料瓶)/,250ml:12.5g:2.25g/瓶,1,,3.47,3.47,3.47

,氢溴酸东莨菪碱注射液/0.3mg:1ml*5/支,0.3mg:1ml*5/支,1,1,1.96,1.96,1.96

,动脉采血,/次,0,1,10.90,0.00,10.90

,静脉采血,/次,1,2,5.40,5.40,10.80

,静脉输液(≤6岁)/组,/组,1,2,9.00,9.00,18.00

,留置静脉针,/组,1,2,7.20,7.20,14.40

3.耗材,一次性留置针(静脉)/洁瑞Y型18G-24G等号,,1,2,14.36,14.36,28.72

,真空采血管/绿头31#,,1,1,1.3,1.30,1.30

,一次性注射器/5ml,,1,1,0.45,0.45,0.45

,一次性采血针/湖北仙明7#,,1,1,0.22,0.22,0.22

,一次性输液器/7#~51/2#(配头皮针,,1,1,1.17,1.17,1.17

,真空采血管/蓝头12#,,1,1,1.62,1.62,1.62

,真空采血管/紫头11#,,3,3,1.62,4.86,4.86

小计,,,,,,827.55,1817.19

二、术中费用,,,,,,,

1.麻醉,麻醉中监测/小时,小时,1,2,61.10,61.10,122.20

,全身麻醉/2小时,2小时,1,2,572.00,572.00,1144.00

,特殊方法气管插管术/次,次,1,1,169.00,169.00,169.00

2.治疗,先心病介入治疗/次,次,1,1,2240.00,2240.00,2240.00

,经皮选择性动脉造影术/次,次,1,1,1170.00,1170.00,1170.00

,临床操作DSA引导(不含临床操作)/每小时,次,1,1,120.00,120.00,120.00

,右心导管检查术/次,次,1,1,1080.00,1080.00,1080.00

,左心导管检查术/次,次,1,1,1188.00,1188.00,1188.00

,临床操作DSA引导(不含临床操作)/每小时,/每小时,1,2,120.00,120.00,240.00

,C型臂术中透视/半小时,,2,4,38,76.00,152.00

,数字化摄影(DR)/次,,2,5,42.8,85.60,214.00

,静脉输液(使用微量泵)加收/小时,小时,6,8,0.50,3.00,4.00

,静脉注药(第二组起)/组,组,3,4,2.00,6.00,8.00

,静脉注射/次,次,1,2,5.40,5.40,10.80

,中心吸氧/小时,小时,2,3,2.70,5.40,8.10

3.药品,氯化钠注射液(0.9%塑料瓶),100ml:0.9g/瓶,1,2,2.80,2.80,5.60

,氯化钠注射液(0.9%塑料安瓿)(H),10ml:0.09g/支,2,8,1.39,2.78,11.12

,注射用头孢唑林钠,0.5g/瓶,0,2,1.80,0.00,3.60

,肝素钠注射液,1.25万单位:2ml*10/支,1,1,9.25,9.25,9.25

,枸橼酸芬太尼注射液/0.1mg:2ml/支,,1,4,4.1,4.10,16.40

,甲硫酸新斯的明注射液/0.5mg:1ml*10/支,,4,4,2.6,10.40,10.40

,盐酸麻黄碱注射液/30mg:1ml/支,,1,2,0.61,0.61,1.22

,硫酸阿托品注射液/0.5mg:1ml*10/支,,1,2,1.6,1.60,3.20

,盐酸纳洛酮注射液/0.4mg:1ml*5/支,,1,1,4.35,4.35,4.35

,氟马西尼注射液/0.2mg:2ml/支,,1,2,32.5,32.50,65.00

,盐酸戊乙奎醚注射液/1mg:1ml/支,,1,1,40.49,40.49,40.49

,复方利多卡因乳膏/5g/支,,5,5,7.598,37.99,37.99

,碘佛醇注射液/50ml:33.9g/瓶,,1,1,128,128.00,128.00

,丙泊酚注射液(J)/0.2g:20ml*5/支,,2,3,75.43,150.86,226.29

,注射用苯磺顺阿曲库铵/10mg/瓶,,1,1,92.44,92.44,92.44

,盐酸托烷司琼注射液(H)/1ml:5mg/支,,1,1,61.67,61.67,61.67

,注射用盐酸瑞芬太尼/2mg*5/支,,1,1,135,135.00,135.00

,葡萄糖氯化钠注射液(5%塑料瓶)/,250ml:12.5g:2.25g/瓶,1,1,3.47,3.47,3.47

4.耗材,动脉鞘/日本各规格(IKII型),,2,2,222.48,444.96,444.96

,一次性注射器/5ml,,2,2,0.45,0.90,0.90

,"一次性注射器(溶药型)/10ml,12#,A型",,1,2,0.7,0.70,1.40

,微量泵延长管/LJG-D,,2,3,0.49,0.98,1.47

,三通接头/德国三通,,1,2,6.73,6.73,13.46

,圈套器/上海各规格,,0,1,3510.15,0.00,3510.15

,"导丝(M型血管造影用)/日本0.035""80/120cm",,1,1,263.52,263.52,263.52

,导丝(交换加硬)/美国0.035*260/502,,1,1,264.6,264.60,264.60

,动脉鞘/日本各规格(IKII型),,2,2,222.48,444.96,444.96

,封堵器/(PDA)北京华医,,1,1,9217.47,9217.47,9217.47

,压力延长管/美国50P112,,2,2,59.24,118.48,118.48

,一次性手术包/新乡市华西血管造影,,1,1,138.24,138.24,138.24

,一次性针筒(高压注射泵用)/四川125mlDSA-N125,,1,1,122.04,122.04,122.04

,造影导管/美国INFINITI,,2,2,202.28,404.56,404.56

,三通接头/浙江HS-TB020二联三通,,2,2,25.92,51.84,51.84

,体腔体温探头/珠海ES-DG-09A,,1,1,272.16,272.16,272.16

,微量泵延长管/LJG-D,,2,2,0.49,0.98,0.98

,吸痰管/浙江A2组合式/一次性,,2,2,3.02,6.04,6.04

,一次性输液接头/佛山肝素帽100只/盒,,1,1,2.48,2.48,2.48

,"一次性输液器(滴定管式)/150ml,5.5#",,1,1,2.17,2.17,2.17

,"一次性吸引管/2.5M,带接头",,1,1,6.05,6.05,6.05

,一次性输液器/A型带针/缓排空型,,2,2,7.45,14.90,14.90

,一次性注射器/1ml31/2#,,2,2,0.56,1.12,1.12

,负压引流器/日月星I型3000ml,,1,1,4.41,4.41,4.41

,呼吸回路/河南驼人/成人/人工鼻,,1,1,162,162.00,162.00

,面罩/苏州氧气成人,,1,1,10.8,10.80,10.80

,气管插管(加强型钢丝)/健琪2.5#-10.5#等各号,,1,1,95.26,95.26,95.26

5.术中监测,动态呼吸监测(呼吸Holter)/次,次,0.5,1,75,37.50,75.00

,血氧饱和度监测/小时,小时,1,1,3.5,3.50,3.50

,持续呼吸功能检测/小时,小时,0.5,1,4.1,2.05,4.10

,无创心功能监测/次,次,0.5,1,46,23.00,46.00

,动脉内压力监测/小时,小时,1,1,11.7,11.70,11.70

,心电监测/小时,小时,1,1,4.1,4.10,4.10

,呼吸机辅助呼吸/小时,小时,0.5,1,9,4.50,9.00

小计：,,,,,,19764.51,24455.41

三、术后恢复,,,,,,,

1.伤口换药,小换药/次,,1,1,10.4000,10.40,10.40

,苯扎氯铵贴/100贴(25mm*18mm)/贴,贴,1,1,0.1850,0.19,0.19

2.术后复查,,,,,,,

常规心电图检查(十二通道),常规心电图检查（床旁心电图加收）/次,次,1,2,5.00,5.00,10.00

,常规心电图检查(十二通道)/次,次,1,2,25.00,25.00,50.00

胸部正位片（DR）,X线摄影(加滤线器计费)加收/个,个,1,1,1.00,1.00,1.00

,数字化摄影(DR)/次,次,1,1,45.00,45.00,45.00

,X线数字化摄影激光胶片/日本柯尼卡14*17in(新,片,1,1,20.52,20.52,20.52

超声心动图,室壁运动分析/次,次,1,1,18.00,18.00,18.00

,心内膜自动边缘检测/次,次,1,1,29.00,29.00,29.00

,心脏彩色多普勒超声/次,次,1,1,85.00,85.00,85.00

,组织多普勒显象(TDI)/次,次,1,1,29.00,29.00,29.00

,左心功能测定/次,次,1,1,45.00,45.00,45.00

,彩色室壁动力(CK)/次,次,1,1,29.00,29.00,29.00

,超声计算机图文报告/次,次,1,1,8.20,8.20,8.20

3.术后用药,氯化钠注射液(0.9%塑料瓶),100ml:0.9g/瓶,12,28,2.80,33.60,78.40

,注射用头孢唑林钠,0.5g/瓶,24,56,1.80,43.20,100.80

,低分子量肝素钠注射液/5000IU:0.4ml/支,,4,6,16.60,66.40,99.