![\"常用的心脏起搏器分类\"](\"http://01luntan.com/ly_img/uimgs/1500809777124.jpg\" "\\"常用的心脏起搏器分类\\"")
动脉导管闭合术中大出血所致的手术死亡率，视导管壁质地、采用闭合导管的手术方式以及手术者技术的高低等而导，一般应在1%以内。导管单纯结扎术或钳闭术有术后导管再通可能，其再通率一般在1%以上，加垫结扎术后复通率低于前二者。动脉导管闭合术的远期效果，视术前有否肺血管继发性病变及其程度。在尚未发生肺血管病变之前接受手术的病人，可完全康复，寿命如常人；肺血管病变严重呈不可逆转者，术后肺血管阻力仍高，右心负荷仍重，效果较差。
","barId":"1704","topicTypeId":null,"topicThemeId":"1023","readLevel":0,"files":"","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":5},{"id":"1604","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"先天性心脏病饮食注意事项","content":"1.严格控制盐的摄入，盐的主要成分是钠和氯，而钠在人体内具有“水化”组织的作用，体内的钠和氯大部分都是从尿中排出的。而血液中钠离子浓度过高会引起体内大量水分的潴留，造成患儿全身水肿、肝脏肿大、增加心脏的负担，严重的还会导致心力衰竭。同时，饮食过咸也是造成高血压的重要原因之一。所以先天性心脏病手术后的患儿的饮食一定要偏淡些，腌腊制品、咸蛋、咸鱼等含盐量过高的食品尽量不要食用。
\n2.不宜多吃巧克力等甜食。心脏手术之后，当小儿不愿意吃饭时，不少家长喜欢塞巧克力给小儿吃，以为这样可以保证营养。巧克力的主要成分是脂肪和糖，热量很高，但所含的蛋白质和脂肪的比例与小儿的正常需要量相差很大。多吃巧克力易造成小儿消化不良、大便秘结、食欲减退。同时巧克力含有咖啡因等成分，食用过多不仅会使小儿过度兴奋、影响休息，而且对小儿的大脑发育带来一定的不良影响。
\n3.不宜多吃罐装饮料和冷饮。目前市场上出售的罐装饮料品种繁多，不少饮料的成分主要是糖或糖精、香料、色素和水，营养却常不足。冷饮也是孩子们都喜欢吃的，但大手术后患儿的消化器官尚处于恢复调整阶段，这时患儿的消化功能往往较弱。过冷的食物进入胃内会刺激胃粘膜血管收缩、胃液分泌减少，影响食物在胃肠道内的消化过程；同时也会减弱消化道的杀菌能力，导致胃肠道发生感染性疾病。
\n4.不宜盲目进补。有些家长认为人参有滋补作用，于是给术后的孩子喝参汤。人参确有强心壮体、补气生津的功能，但不同的人参具有不同的性能，服用不当反会引起胃口减退、鼻子出血、烦躁不安等症状。另有一些补品对生长发育期间的孩子并不适宜。
\n最好的术后“补品”乃是天然食物。家长只要按着上述的几项原则，在孩子每天的饮食中注意荤素搭配、粗细均衡，在烹调时注意防止营养素的丧失和破坏，确保一日三餐吃饱、吃好，孩子一定会尽快恢复体力的。
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血清甘油三酯的正常是多少？甘油三酯偏高的危害有哪些
","barId":"1704","topicTypeId":null,"topicThemeId":"1020","readLevel":0,"files":"","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":5},{"id":"5439","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"常用的心脏起搏器分类","content":"常用的心脏起搏器分类,适合自己病情的才是真正的好
\n1、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。
\n2、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。
\n3、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。
\n
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。
\n5、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。
\n","barId":"1704","topicTypeId":null,"topicThemeId":"1019","readLevel":0,"files":"","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":6},{"id":"2000","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"动脉导管未闭的孩子有什么表现","content":"
动脉导管未闭的症状取决于导管的粗细、分流量的大小、肺血管阻力的高低、患者年龄以及 是否合并其他先天性心脏病。
\n足月患婴即使导管粗大，需出生后6～8周，待肺血管阻力下降后才出现症状。早产婴儿由于肺小动脉平滑肌较少，血管阻力较早下降，故于第一周即可有症状，往往出现气促、心动过速和急性呼吸困难等，于哺乳时更为明显，且易患感冒以及上呼吸道感染、肺炎等。
\n小儿期得到代偿，很少有自觉症状，只是发育欠佳，身材瘦小。有些儿童仅在劳累后易感到疲乏、心悸。
\n未闭导管中等大小患者一般都无症状，直至20多岁剧烈活动后才出现气急、心悸等心功能失代偿症状。
\n肺动脉高压虽然可在2岁以下出现，但明显的肺动脉高压征候大都在年龄较大才表现出头晕、气促、咯血、活动后发绀（多以下半身发绀明显）。
\n若并发亚急性心内膜炎（心脏内膜感染），则有发热、食欲不振、出汗等全身症状。心内膜炎在儿童期很少发生，而以青年期多见。
\n","barId":"1704","topicTypeId":null,"topicThemeId":"1016","readLevel":0,"files":"","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":5},{"id":"2172","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"先天性心脏病动脉导管未闭怎么回事","content":"
每个婴儿出生时均有一个动脉导管，这是位于两个主要血管肺动脉和主动脉之间的通道。肺动脉内流着蓝色的静脉血由心脏的右侧流向肺脏。在肺内静脉血摄取氧气成为含氧的红色的动脉血。主动脉携带红色的含氧的动脉血运行到身体的其他部分。
\n动脉导管在胎儿期间是血液运行的正常通道，出生后不再需要而在几天内逐渐闭合。如果动脉导管未能闭合，就是动脉导管未闭，常见于早产儿，而在足月新生儿中少见。对于大多数患儿，动脉导管未闭的原因不明。
\n正常情况下，左侧心脏只泵血到主动脉，而右侧心脏只泵血刀肺动脉。动脉导管未闭时，部分血液由主动脉流入肺动脉。当动脉导管较粗时，分流的血液需要心脏加倍作功并导致肺充血。
\n当动脉导管较细时，可能没有明显的临床症状，而只能听到明显的杂音。但当动脉导管较粗时，患儿可能呼吸急促，婴儿可能难以喂养并发育迟缓。症状可能在出生后几周才出现。由于肺血增多而引起肺动脉压力增高，久而久之肺血管发生器质性改变。
\n对于较细的动脉导管，一般不需要治疗，通常会在出生后几个月内自行闭合。对于较粗的动脉导管，可以通过介入治疗进行封堵或通过手术进行结扎治疗。对于早产儿，可以通过药物促进动脉导管闭合，如果几周后还没有闭合，可以通过外科手术结扎。
\n对于较细的动脉导管或已经封堵或手术后的患儿，可以完全正常地参加日常活动，远期预后良好。
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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。
\n![\"简单几句话让你明白心脏起搏器原理\"](\"http://01luntan.com/ly_img/uimgs/1500739398481.JPEG\" "\\"简单几句话让你明白心脏起搏器原理\\"")
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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