{"countAll":0,"orderType":null,"readLevel":"0","lyTopicReq":{"id":"1704","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":null,"content":null,"barId":"1704","topicTypeId":null,"topicThemeId":"1019","readLevel":0,"files":null,"clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":null},"lyBarModerators":{"list":[],"list4Map":null,"pageBegin":0,"pageSize":8,"pageNumber":0,"totalPage":0,"totalRow":0},"metaSearch":{"description":"洞医为您提供:北京协和心内科专家、北京协和医院心律失常、北京协和医院心内科病友的治疗经验等相关信息，让您在便捷的求医路上不花一分冤枉钱。","keywords":"北京协和心内科专家_北京协和医院心律失常_北京协和医院心内科_洞医","title":"北京协和心内科专家_北京协和医院心律失常_北京协和医院心内科_洞医","channels":null},"data":{"list":[{"id":"5489","isDel":0,"createAt":1501902420926,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"userId":"b1a5ca4ddfad11e6a61c00163e04584d","title":"冠状动脉支架价格知多少","content":"

  在临床中，许多病友都会关心一个问题：冠状动脉支架价格大概多钱收？心脏支架手术费用全部下来多少去吗？我们普通老百姓冠状动脉支架手术费用能负担的起吗？在了解这些相关费用之前，不妨来看看整个冠状动脉支架手术费用究竟使用在什么地方？

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\"冠状动脉支架价格知多少\"

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  对于冠心病、心脏病的支架手术，通常是在桡动脉或股动脉进行穿刺，穿刺的目的是送入动脉鞘管作为手术路径。鞘管可以理解为一个阀门，可以送入器械，但血液流不出来。在手术结束后拔除鞘管即可，压迫止血或使用血管闭合器。

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  冠状动脉支架手术前必须完成冠状动脉造影检查，通过该项检查来了解冠状动脉解剖结构和冠状动脉病变的部位和严重程度。冠脉造影这部分费用大概是三千到四千元，不同级别的医院收费也不等。

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\"冠状动脉支架价格知多少\"

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  冠状动脉支架手术，需要将导引导管放在冠状动脉开口部，再将特制的导引导丝送到拟治疗的靶血管的远端，然后沿导丝把预扩张球囊导管送到病变处进行预扩张，以此来进行支架精确定位、扩张、释放，最后再用后扩张球囊导管进行后扩张让支架充分膨胀并紧紧贴在血管壁上，不留缝隙。

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  冠状动脉支架在未释放之前是固定在球囊导管上的，释放之后犹如一个紧贴血管壁的小弹簧圈一般不会发生弹性回缩。

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\"冠状动脉支架价格知多少\"

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  冠状动脉支架手术所用的支架的材料可分为医用不锈钢、镍铬或铂铬合金等等， 现在支架绝大部分是药物涂层支架。冠状动脉支架手术的费用因置入支架材料、支架数量以及辅助器械的用量不同而不同。

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  对一些特殊患者，可能还需要做血管内超声、光学相干断层扫描、冠脉血流储备分数等相关检查，以精确了解病变性质和特点，以此来确定最优化的手术方案。特别是重度钙化的病变，还要提前进行冠状动脉旋磨术，才能置入支架。旋磨术也会产生一笔不菲的费用。

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  旋磨术手术中的支架除了材料差异外，还有国产进口之分，价格相差较大。国产的药物涂层支架单价约8000-12000元，进口药物涂层支架单价大约15000-16000元。

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  手术中所需支架数量，主要视病情来决定，因此整个冠状动脉支架手术费用，主要由支架类型及数量来确定，通常情况下一枚国产支架总的手术费用大概2万5千-3万元，植入二枚国产支架的总手术费用约3万-3万5千；植入一枚进口支架总的费用大概3万5千到4万，二个进口支架手术费用大约需4万5千到5万。因此心脏支架手术的费用一般在3-6万元之间，其中主要的花费就是消耗的心脏支架和球囊导管的材料费用。

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    部分冠心病患者是严重三支血管病变，需分次心脏介入手术，使用的支架数量多，全部的手术费用相当昂贵。如果需要植入的支架数量在三枚以上，从治疗效果和经济费用上看，应选择冠脉搭桥手术更为划算。

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重点提示：

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    冠状动脉支架手术后仍然离不开长期的规则药物治疗，积极控制各种致病因素（如高血压、高血脂、高血糖等），另外也需要改进饮食和生活习惯，增加体力活动或锻炼。不然在数年之后，又会产生新的病变，或原病变再生重新堵塞血管，这样就需要重新进行心脏支架手术了，届时费用无疑更加庞大。

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    目前支架、球囊导管等手术耗材都已纳入医保报销范围。植入性材料3万以内可以医保报销，超过部分完全自费，球囊导管和其他的辅助材料不能超过4万。如此计算，参加医保的个人需要支付的费用大概在1万到2万之间，作为患者或者家属要在术前，根据病情的需要，结合自身经济承受能力，选择最佳的治疗方案。

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常用的心脏起搏器分类,适合自己病情的才是真正的好

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1、心房按需型：电极置于心房。起搏器按规定的周长或频率发放脉冲起搏心房，并下传激动心室，以保持心房和心室的顺序收缩。如果有自身的心房搏动，起搏器能感知自身的P波，起抑制反应，并重整脉冲发放周期，避免心房节律竞争。

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2、心室按需型：电极置于心室。起搏器按规定的周长或频率发放脉冲起搏心室，如果有自身的心搏，起搏器能感知自身心搏的QRS波，起抑制反应，并重整脉冲发放周期，避免心律竞争。但这型起搏器只保证心室起搏节律，而不能兼顾保持心房与心室收缩的同步、顺序、协调，因而是非生理性的。

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3、双腔起搏器：心房和心室都放置电极。如果自身心率慢于起搏器的低限频率，导致心室传导功能有障碍，则起搏器感知P波触发心室起搏（呈VDD工作方式）。如果心房（P）的自身频率过缓，但房室传导功能是好的，则起搏器起搏心房，并下传心室（呈AAI工作方式）。这种双腔起搏器的逻辑，总能保持心房和心室得到同步、顺序、协调的收缩。如果只需采用VDD工作方式，可用单导线VDD起搏器，比放置心房和心室两根导线方便得多。

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\"常用的心脏起搏器分类\"

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4、频率自适应（R）起搏器：本型起搏器的起搏频率能根据机体对心排血量（即对需氧量）的要求而自动调节适应，起搏频率加快，则心排血量相应增加，满足机体生理需要。目前使用的频率自适应起搏器，多数是体动型的，也有一部分是每分钟通气量型的。具有频率自适应的VVI起搏器，称为VVIR型；具有频率自适应的AAI起搏器，称为AAIR型；具有频率自适应的DDD起搏器，称为DDDR型。以上心房按需起搏器、双腔起搏器、频率自适应起搏器都属于生理性起搏器。

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5、起搏器的程序控制功能：指埋藏在体内的起搏器，可以在体外用程序控制器改变其工作方式及工作参数。埋植起搏器后，可以根据机体的具体情况，规定一套最适合的工作方式和工作参数，使起搏器发挥最好的效能，资金节省上能而保持最长的使用寿限，有些情况下还可无创性地排除一些故障，程控功能的扩展，可使起搏器具有贮存资料、监测心律、施行电生理检查的功能。

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　　心脏起搏器原理简单的相容来说就是一个人工的“司令部”，它的主要作用就是替代心脏的起搏点，使心脏有节律地跳动起来。心脏起搏器是由电池和电路组成的脉冲发生器组成，能定时发放一定频率的脉冲电流，通过起搏电极导线传输到心房或心室肌，使局部的心肌细胞受到刺激而兴奋，兴奋通过细胞间的传导扩散传布，导致整个心房和（或）心室的收缩。心脏的电信号使它跳动。当运行时，心脏跳动加速；当睡眠时，心脏跳动减慢。如果心电系统异常，心脏跳得很慢，甚至可能完全停止。人工心脏起膊器发出有规律的电脉冲，能使心脏保持跳动。

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\"简单几句话让你明白心脏起搏器原理\"

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　　早期的人工心脏起搏器的电池部分装在身体的外部，导线从体外通过静脉到达心脏。患者只能在医院内短期使用。后来，鲁内•埃尔姆奎斯特在1958年制作了一个放在体内起搏器，锌一汞电波埋在皮下。1960年，瑞典医生奥克•森宁为一位病人植入了这种起搏器。电池一直使用了2---3年才更换。在20世纪80年代，起搏器上增加了微处理器。只有在感觉需要起搏器时，病人才启动它。今天的起搏器就更复杂了，起搏器可根据血液的湿度来调节心跳。1988年，一位病人安装了一个核动力起搏器。这个起搏器使用了微量的钚，可以持续应用20年。从这心脏起搏器的发展之路就可以看出，心脏起搏器已经越来越智能，更换电池时间越来越久。

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男,66岁。扩张性心脏病。四肢无力，多汗，腰疼，怕累，气喘，有什么办法治疗或使心脏缩小到正常范围，这种扩张性心脏病能治愈吗

","barId":"1704","topicTypeId":"2","topicThemeId":"1019","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1626,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1486782816680,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1486782816678,"metaSearch":null,"rn":0,"barTitle":null,"checkcode":null,"forumUser":{"id":"6aad1b12ea7211e6a61c00163e04584d","isDel":0,"createAt":1486168781822,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"username":"茉莉花","password":"888888","level":0,"nickName":"茉莉花","realName":null,"signName":"随遇而安","head":"http://01luntan.com/ly_img/1486169681471.jpg","phone":null,"mobile":null,"wechat":null,"qq":null,"email":null,"address":null,"identityType":1,"userType":2,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":2,"provinceId":"140000","cityId":"140500","userLevel":0,"modifyNameCount":1},"lyTopicReply":null,"createAtStr":null,"lyBar":null,"lyTopic":null},{"id":"1280","isDel":0,"createAt":1486777231948,"createBy":"623d560be20c11e6a61c00163e04584d","createName":"期缘","updateAt":0,"updateBy":null,"updateName":null,"userId":"623d560be20c11e6a61c00163e04584d","title":"心衰心肌缺血一般用什么药","content":"

我妈妈五年前患心衰，近一两年患心肌缺血。劳累，熬夜会发病，发病时心脏颤、嘚瑟，耳鸣，并伴有脸、脚心发热。脸有水肿，有时脑袋疼，睡眠不好，没有力气。心衰心肌缺血一般用什么药，希望帮忙推荐下

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我是孩子妈妈，一个快要崩溃的妈妈，孩子3岁查出室性早搏，这些年断断续续治疗，8岁做过心脏彩超正常，左室假键索，现在孩子12周岁，今天做心脏彩超提示；左房，左室大；左室收缩，舒张功能正常。彩色血流提示：二1尖瓣，三尖瓣返流（少量）。示波下早搏。医生建议立即做射频手术.

我想知道，孩子的这种情况不手术可以吗，是不是除了手术别无选择。我四十多岁了，孩子跟着我受了不少苦，我内心自责的无法形容

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男,57岁。2016年12月27日发病并于当天做了脑部钻两个孔引流手术，2017年1月13日拆管，1月22日做气管切开手术，2017年2月1日的状况是血压偏低靠升压药控制，肝的转氨酶有点偏高

\n

现在是丘脑出血深度昏迷，有什么方法可帮助脑功能和自主呼吸恢复？

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