單病種經(jīng)皮動(dòng)脈導(dǎo)管未閉封堵術(shù)臨床路徑費(fèi)用明細(xì)表1（按階段）

單病種病態(tài)竇房結(jié)綜合征單腔永久起搏器植入臨床路徑費(fèi)用明細(xì)表1（按階段）,,,,,,,

類別,項(xiàng)目名稱,規(guī)格,數(shù)量（最小）,數(shù)量（最大）,單價(jià)/元,總價(jià)/元（min）,總價(jià)/元（max）

一、入院及術(shù)前準(zhǔn)備,,,,,,,

1.入院檢查,,,,,,,

血細(xì)胞分析+超敏C+血型鑒定,C—反應(yīng)蛋白測定(CRP),項(xiàng),1,1,8.40,8.40,8.40

,超敏C反應(yīng)蛋白測定（免疫熒光法）,次,1,1,45.00,45.00,45.00

,全血細(xì)胞計(jì)數(shù)+五分類,套,1,1,25.00,25.00,25.00

,網(wǎng)織紅細(xì)胞計(jì)數(shù)(Ret)(儀器法),項(xiàng),1,1,6.00,6.00,6.00

,Rh血型鑒定/次（必要時(shí)）,次,0,1,11.00,0.00,11.00

,ABO紅細(xì)胞定型/次,次,1,1,3.60,3.60,3.60

凝血五項(xiàng)+FDP,活化部分凝血活酶時(shí)間測定(APTT)(儀器法)/,項(xiàng),1,2,15.00,15.00,30.00

,凝血酶時(shí)間測定(TT)(儀器法)/項(xiàng),項(xiàng),1,2,20.00,20.00,40.00

,纖維蛋白(原)降解產(chǎn)物測定(FDP)(儀器法)/項(xiàng),項(xiàng),1,2,45.00,45.00,90.00

,血漿D-二聚體測定(D-Dimer)(各種免疫學(xué)方法)/項(xiàng),項(xiàng),1,2,80.00,80.00,160.00

,血漿凝血酶原時(shí)間測定(PT)(儀器法)/項(xiàng),項(xiàng),1,2,15.00,15.00,30.00

,血漿纖維蛋白原測定(儀器法)/項(xiàng),項(xiàng),1,2,20.00,20.00,40.00

腎功能,肌酐測定/項(xiàng),項(xiàng),1,1,7.10,7.10,7.10

,內(nèi)生肌酐清除率試驗(yàn)/項(xiàng),項(xiàng),1,1,8.00,8.00,8.00

,尿素測定/項(xiàng),項(xiàng),1,1,7.00,7.00,7.00

,血清尿酸測定/項(xiàng),項(xiàng),1,1,7.20,7.20,7.20

,血清碳酸氫鹽(HCO3)測定/項(xiàng),項(xiàng),1,1,9.20,9.20,9.20

,血清胱抑素(CystatinC)測定/項(xiàng),項(xiàng),1,1,15.00,15.00,15.00

電解質(zhì),鉀測定/項(xiàng),項(xiàng),1,1,5.00,5.00,5.00

,鈣測定/項(xiàng),項(xiàng),1,1,5.00,5.00,5.00

,氯測定/項(xiàng),項(xiàng),1,1,5.00,5.00,5.00

,鈉測定/項(xiàng),項(xiàng),1,1,5.00,5.00,5.00

血?dú)夥治?全血乳酸測定/項(xiàng),項(xiàng),1,8,12.30,12.30,98.40

,血?dú)夥治?次,次,1,8,42.00,42.00,336.00

微量血糖測定,葡萄糖測定(干化學(xué)法)/次,次,1,7,15.00,15.00,105.00

免疫三項(xiàng),丙型肝炎抗體測定(Anti-HCV)/項(xiàng),項(xiàng),1,1,21.90,21.90,21.90

,梅毒螺旋體特異抗體測定/項(xiàng),項(xiàng),1,1,15.00,15.00,15.00

,人免疫缺陷病毒抗體測定(Anti-HIV)/項(xiàng),項(xiàng),1,1,22.80,22.80,22.80

尿常規(guī),尿常規(guī)檢查/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,腺苷脫氨酶測定/項(xiàng),項(xiàng),1,1,8.00,8.00,8.00

,血清α-L-巖藻糖苷酶測定/項(xiàng),項(xiàng),1,1,7.70,7.70,7.70

,血清γ-谷氨酰基轉(zhuǎn)移酶測定/項(xiàng),項(xiàng),1,1,5.00,5.00,5.00

,血清白蛋白測定/項(xiàng),項(xiàng),1,1,3.50,3.50,3.50

,血清丙氨酸氨基轉(zhuǎn)移酶測定/項(xiàng),項(xiàng),1,1,5.00,5.00,5.00

,血清膽堿脂酶測定/項(xiàng),項(xiàng),1,1,8.20,8.20,8.20

,血清間接膽紅素測定/項(xiàng),項(xiàng),1,1,4.00,4.00,4.00

,血清堿性磷酸酶測定/項(xiàng),項(xiàng),1,1,5.00,5.00,5.00

,血清前白蛋白測定/項(xiàng),項(xiàng),1,1,9.40,9.40,9.40

,血清天門冬氨酸氨基轉(zhuǎn)移酶測定/項(xiàng),項(xiàng),1,1,5.00,5.00,5.00

,血清直接膽紅素測定/項(xiàng),項(xiàng),1,1,4.00,4.00,4.00

,血清總膽汁酸測定/項(xiàng),項(xiàng),1,1,12.00,12.00,12.00

,血清總蛋白測定/項(xiàng),項(xiàng),1,1,3.60,3.60,3.60

,血清總膽紅素測定/項(xiàng),項(xiàng),1,1,4.00,4.00,4.00

,血清總膽固醇測定/項(xiàng),項(xiàng),1,1,4.00,4.00,4.00

乙肝表面抗原測定,乙型肝炎表面抗原測定(HBsAg)(定量)/項(xiàng),項(xiàng),1,1,15.00,15.00,15.00

大便常規(guī)+隱血,糞便常規(guī)/次,項(xiàng),1,1,2.50,2.50,2.50

,糞便隱血試驗(yàn)(OB)(免疫法)/項(xiàng),項(xiàng),1,1,6.00,6.00,6.00

,糞寄生蟲鏡檢/次,次,1,1,4.60,4.60,4.60

常規(guī)心電圖檢查(十二通道),常規(guī)心電圖檢查（床旁心電圖加收）/次,次,1,1,5.00,5.00,5.00

,常規(guī)心電圖檢查(十二通道)/次,次,1,1,25.00,25.00,25.00

超聲心動(dòng)圖,室壁運(yùn)動(dòng)分析/次,次,0,1,18.00,0.00,18.00

,心內(nèi)膜自動(dòng)邊緣檢測/次,次,0,1,29.00,0.00,29.00

,心臟彩色多普勒超聲/次,次,0,1,85.00,0.00,85.00

,組織多普勒顯象(TDI)/次,次,0,1,29.00,0.00,29.00

,左心功能測定/次,次,0,1,45.00,0.00,45.00

,彩色室壁動(dòng)力(CK)/次,次,0,1,29.00,0.00,29.00

,超聲計(jì)算機(jī)圖文報(bào)告/次,次,0,1,8.20,0.00,8.20

胸部正側(cè)位片,X線攝影(加濾線器計(jì)費(fèi))加收/個(gè),個(gè),2,2,1.00,2.00,2.00

,數(shù)字化攝影(DR)/次,次,2,2,45.00,90.00,90.00

,X線數(shù)字化攝影激光膠片/日本柯尼卡14*17in(新,片,2,2,20.52,41.04,41.04

2.藥品、治療相關(guān)項(xiàng)目,氯化鈉注射液(0.9%塑料瓶),100ml:0.9g/瓶,0,2,2.80,0.00,5.60

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

,注射用頭孢唑林鈉,0.5g/瓶,0,2,1.80,0.00,3.60

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

,氫溴酸東莨菪堿注射液/0.3mg:1ml*5/支,0.3mg:1ml*5/支,1,1,1.96,1.96,1.96

,動(dòng)脈采血,/次,0,1,10.90,0.00,10.90

,靜脈采血,/次,1,2,5.40,5.40,10.80

,靜脈輸液(≤6歲)/組,/組,1,2,9.00,9.00,18.00

,留置靜脈針,/組,1,2,7.20,7.20,14.40

3.耗材,一次性留置針(靜脈)/潔瑞Y型18G-24G等號,,1,2,14.36,14.36,28.72

,真空采血管/綠頭31#,,1,1,1.3,1.30,1.30

,一次性注射器/5ml,,1,1,0.45,0.45,0.45

,一次性采血針/湖北仙明7#,,1,1,0.22,0.22,0.22

,一次性輸液器/7#~51/2#(配頭皮針,,1,1,1.17,1.17,1.17

,真空采血管/藍(lán)頭12#,,1,1,1.62,1.62,1.62

,真空采血管/紫頭11#,,3,3,1.62,4.86,4.86

小計(jì),,,,,,827.55,1817.19

二、術(shù)中費(fèi)用,,,,,,,

1.麻醉,麻醉中監(jiān)測/小時(shí),小時(shí),1,2,61.10,61.10,122.20

,全身麻醉/2小時(shí),2小時(shí),1,2,572.00,572.00,1144.00

,特殊方法氣管插管術(shù)/次,次,1,1,169.00,169.00,169.00

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

,經(jīng)皮選擇性動(dòng)脈造影術(shù)/次,次,1,1,1170.00,1170.00,1170.00

,臨床操作DSA引導(dǎo)(不含臨床操作)/每小時(shí),次,1,1,120.00,120.00,120.00

,右心導(dǎo)管檢查術(shù)/次,次,1,1,1080.00,1080.00,1080.00

,左心導(dǎo)管檢查術(shù)/次,次,1,1,1188.00,1188.00,1188.00

,臨床操作DSA引導(dǎo)(不含臨床操作)/每小時(shí),/每小時(shí),1,2,120.00,120.00,240.00

,C型臂術(shù)中透視/半小時(shí),,2,4,38,76.00,152.00

,數(shù)字化攝影(DR)/次,,2,5,42.8,85.60,214.00

,靜脈輸液(使用微量泵)加收/小時(shí),小時(shí),6,8,0.50,3.00,4.00

,靜脈注藥(第二組起)/組,組,3,4,2.00,6.00,8.00

,靜脈注射/次,次,1,2,5.40,5.40,10.80

,中心吸氧/小時(shí),小時(shí),2,3,2.70,5.40,8.10

3.藥品,氯化鈉注射液(0.9%塑料瓶),100ml:0.9g/瓶,1,2,2.80,2.80,5.60

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

,注射用頭孢唑林鈉,0.5g/瓶,0,2,1.80,0.00,3.60

,肝素鈉注射液,1.25萬單位:2ml*10/支,1,1,9.25,9.25,9.25

,枸櫞酸芬太尼注射液/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

,鹽酸麻黃堿注射液/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

,鹽酸納洛酮注射液/0.4mg:1ml*5/支,,1,1,4.35,4.35,4.35

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

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

,復(fù)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

,注射用苯磺順阿曲庫銨/10mg/瓶,,1,1,92.44,92.44,92.44

,鹽酸托烷司瓊注射液(H)/1ml:5mg/支,,1,1,61.67,61.67,61.67

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

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

4.耗材,動(dòng)脈鞘/日本各規(guī)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(溶藥型)/10ml,12#,A型",,1,2,0.7,0.70,1.40

,微量泵延長管/LJG-D,,2,3,0.49,0.98,1.47

,三通接頭/德國三通,,1,2,6.73,6.73,13.46

,圈套器/上海各規(guī)格,,0,1,3510.15,0.00,3510.15

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

,導(dǎo)絲(交換加硬)/美國0.035*260/502,,1,1,264.6,264.60,264.60

,動(dòng)脈鞘/日本各規(guī)格(IKII型),,2,2,222.48,444.96,444.96

,封堵器/(PDA)北京華醫(yī),,1,1,9217.47,9217.47,9217.47

,壓力延長管/美國50P112,,2,2,59.24,118.48,118.48

,一次性手術(shù)包/新鄉(xiāng)市華西血管造影,,1,1,138.24,138.24,138.24

,一次性針筒(高壓注射泵用)/四川125mlDSA-N125,,1,1,122.04,122.04,122.04

,造影導(dǎo)管/美國INFINITI,,2,2,202.28,404.56,404.56

,三通接頭/浙江HS-TB020二聯(lián)三通,,2,2,25.92,51.84,51.84

,體腔體溫探頭/珠海ES-DG-09A,,1,1,272.16,272.16,272.16

,微量泵延長管/LJG-D,,2,2,0.49,0.98,0.98

,吸痰管/浙江A2組合式/一次性,,2,2,3.02,6.04,6.04

,一次性輸液接頭/佛山肝素帽100只/盒,,1,1,2.48,2.48,2.48

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

,"一次性吸引管/2.5M,帶接頭",,1,1,6.05,6.05,6.05

,一次性輸液器/A型帶針/緩排空型,,2,2,7.45,14.90,14.90

,一次性注射器/1ml31/2#,,2,2,0.56,1.12,1.12

,負(fù)壓引流器/日月星I型3000ml,,1,1,4.41,4.41,4.41

,呼吸回路/河南駝人/成人/人工鼻,,1,1,162,162.00,162.00

,面罩/蘇州氧氣成人,,1,1,10.8,10.80,10.80

,氣管插管(加強(qiáng)型鋼絲)/健琪2.5#-10.5#等各號,,1,1,95.26,95.26,95.26

5.術(shù)中監(jiān)測,動(dòng)態(tài)呼吸監(jiān)測(呼吸Holter)/次,次,0.5,1,75,37.50,75.00

,血氧飽和度監(jiān)測/小時(shí),小時(shí),1,1,3.5,3.50,3.50

,持續(xù)呼吸功能檢測/小時(shí),小時(shí),0.5,1,4.1,2.05,4.10

,無創(chuàng)心功能監(jiān)測/次,次,0.5,1,46,23.00,46.00

,動(dòng)脈內(nèi)壓力監(jiān)測/小時(shí),小時(shí),1,1,11.7,11.70,11.70

,心電監(jiān)測/小時(shí),小時(shí),1,1,4.1,4.10,4.10

,呼吸機(jī)輔助呼吸/小時(shí),小時(shí),0.5,1,9,4.50,9.00

小計(jì)：,,,,,,19764.51,24455.41

三、術(shù)后恢復(fù),,,,,,,

1.傷口換藥,小換藥/次,,1,1,10.4000,10.40,10.40

,苯扎氯銨貼/100貼(25mm*18mm)/貼,貼,1,1,0.1850,0.19,0.19

2.術(shù)后復(fù)查,,,,,,,

常規(guī)心電圖檢查(十二通道),常規(guī)心電圖檢查（床旁心電圖加收）/次,次,1,2,5.00,5.00,10.00

,常規(guī)心電圖檢查(十二通道)/次,次,1,2,25.00,25.00,50.00

胸部正位片（DR）,X線攝影(加濾線器計(jì)費(fèi))加收/個(gè),個(gè),1,1,1.00,1.00,1.00

,數(shù)字化攝影(DR)/次,次,1,1,45.00,45.00,45.00

,X線數(shù)字化攝影激光膠片/日本柯尼卡14*17in(新,片,1,1,20.52,20.52,20.52

超聲心動(dòng)圖,室壁運(yùn)動(dòng)分析/次,次,1,1,18.00,18.00,18.00

,心內(nèi)膜自動(dòng)邊緣檢測/次,次,1,1,29.00,29.00,29.00

,心臟彩色多普勒超聲/次,次,1,1,85.00,85.00,85.00

,組織多普勒顯象(TDI)/次,次,1,1,29.00,29.00,29.00

,左心功能測定/次,次,1,1,45.00,45.00,45.00

,彩色室壁動(dòng)力(CK)/次,次,1,1,29.00,29.00,29.00

,超聲計(jì)算機(jī)圖文報(bào)告/次,次,1,1,8.20,8.20,8.20

3.術(shù)后用藥,氯化鈉注射液(0.9%塑料瓶),100ml:0.9g/瓶,12,28,2.80,33.60,78.40

,注射用頭孢唑林鈉,0.5g/瓶,24,56,1.80,43.20,100.80

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