541 lines
14 KiB
Plaintext
541 lines
14 KiB
Plaintext
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{
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"Version":"6.6.6.6",
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"Font":{
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"Name":"宋体",
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"Size":105000,
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"Weight":400,
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"Charset":134
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},
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"Printer":{
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},
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"DetailGrid":{
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"Recordset":{
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"Field":[
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{
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"Name":"DoctorSignatureTime",
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"DBFieldName":"医护签字时间"
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},
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{
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"Name":"PatientSignatureTime",
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"DBFieldName":"患者签名时间"
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},
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{
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"Name":"Name",
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"DBFieldName":"姓名"
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},
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{
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"Name":"Age",
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"DBFieldName":"年龄"
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},
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{
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"Name":"Gender",
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"DBFieldName":"性别"
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},
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{
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"Name":"Relationship",
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"DBFieldName":"关系"
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},
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{
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"Name":"Number",
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"DBFieldName":"病历号"
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},
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{
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"Name":"DoctorSignature",
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"Type":"Binary",
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"DBFieldName":"医护人员签字"
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},
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{
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"Name":"PatientSignature",
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"Type":"Binary",
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"DBFieldName":"患者签字"
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},
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{
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"Name":"Agree",
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"DBFieldName":"是否同意"
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}
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]
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},
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"ColumnContent":{
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},
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"ColumnTitle":{
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}
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},
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"ReportHeader":[
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{
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"Name":"ReportHeader1",
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"Height":33.999,
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"Control":[
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{
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"Type":"StaticBox",
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"Name":"StaticBox2",
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"Left":0.396875,
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"Top":1.27,
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"Width":1.34938,
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"Height":0.47625,
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"Font":{
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"Name":"宋体",
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"Size":120000,
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"Weight":400,
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"Charset":134
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},
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"Text":"姓名："
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},
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{
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"Type":"StaticBox",
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"Name":"StaticBox3",
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"Left":3.70417,
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"Top":1.27,
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"Width":1.34938,
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"Height":0.47625,
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"Font":{
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"Name":"宋体",
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"Size":120000,
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"Weight":400,
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"Charset":134
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},
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"Text":"性别："
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},
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{
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"Type":"StaticBox",
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"Name":"StaticBox4",
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"Left":6.79979,
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"Top":1.27,
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"Width":1.40229,
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"Height":0.47625,
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"Font":{
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"Name":"宋体",
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"Size":120000,
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"Weight":400,
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"Charset":134
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},
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"Text":"年龄："
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},
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{
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"Type":"StaticBox",
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"Name":"StaticBox8",
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"Left":0.396875,
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"Top":30.7181,
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"Width":2.61938,
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"Height":0.47625,
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"Font":{
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"Name":"宋体",
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"Size":120000,
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"Weight":400,
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"Charset":134
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},
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"Text":"医护人员签名"
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},
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{
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"Type":"StaticBox",
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"Name":"StaticBox9",
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"Left":10.0013,
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"Top":27.1463,
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"Width":1.77271,
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"Height":0.47625,
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"Font":{
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"Name":"宋体",
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"Size":120000,
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"Weight":400,
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"Charset":134
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},
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"Text":"签名时间"
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},
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{
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"Type":"FieldBox",
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"Name":"FieldBox3",
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"Left":1.79917,
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"Top":1.19063,
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"Width":1.61396,
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"Height":0.608542,
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"Font":{
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"Name":"宋体",
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"Size":120000,
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"Weight":400,
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"Charset":134
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},
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"DataField":"Name"
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},
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{
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"Type":"FieldBox",
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"Name":"FieldBox5",
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"Left":5.21229,
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"Top":1.19063,
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"Width":1.19063,
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"Height":0.608542,
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"Font":{
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"Name":"宋体",
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"Size":120000,
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"Weight":400,
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"Charset":134
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},
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"DataField":"Gender"
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},
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{
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"Type":"FieldBox",
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"Name":"FieldBox7",
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"Left":8.38729,
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"Top":1.19063,
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"Width":1.40229,
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"Height":0.608542,
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"Font":{
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"Name":"宋体",
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"Size":120000,
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"Weight":400,
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"Charset":134
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},
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"DataField":"Age"
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},
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{
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"Type":"FieldBox",
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"Name":"FieldBox10",
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"Left":12.0121,
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"Top":27.0933,
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"Width":3.59833,
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"Height":0.582083,
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"Font":{
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"Name":"宋体",
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"Size":120000,
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"Weight":400,
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"Charset":134
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},
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"DataField":"PatientSignatureTime"
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},
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{
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"Type":"StaticBox",
|
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"Name":"StaticBox10",
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"Left":3.20146,
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"Top":0.211667,
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"Width":9.07521,
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"Height":0.555625,
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"Font":{
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"Name":"宋体",
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"Size":142500,
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"Bold":true,
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"Charset":134
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},
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"TextAlign":"MiddleCenter",
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|||
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"Text":"颈动脉血管成型支架植入术知情同意书"
|
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},
|
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{
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|||
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"Type":"StaticBox",
|
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"Name":"StaticBox11",
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|||
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"Left":10.0013,
|
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"Top":1.27,
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"Width":1.5875,
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"Height":0.47625,
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"Font":{
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|||
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|
"Name":"宋体",
|
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|
|
"Size":120000,
|
|||
|
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"Weight":400,
|
|||
|
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"Charset":134
|
|||
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},
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"Text":"病历号："
|
|||
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},
|
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{
|
|||
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"Type":"FieldBox",
|
|||
|
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"Name":"FieldBox11",
|
|||
|
|
"Left":11.8004,
|
|||
|
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"Top":1.19063,
|
|||
|
|
"Width":2.80458,
|
|||
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"Height":0.608542,
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"Font":{
|
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|
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"Name":"宋体",
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|
|
"Size":120000,
|
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|
|
"Weight":400,
|
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|
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"Charset":134
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},
|
|||
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"DataField":"Number"
|
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},
|
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{
|
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|
|
"Type":"StaticBox",
|
|||
|
|
"Name":"StaticBox12",
|
|||
|
|
"Left":0.396875,
|
|||
|
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"Top":2.19604,
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|||
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"Width":10.2394,
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"Height":0.47625,
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"Font":{
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"Name":"宋体",
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"Size":120000,
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|
"Weight":400,
|
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|
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"Charset":134
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},
|
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"Text":"患者因患于收住入院。经行全脑血管造影术检查发现："
|
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},
|
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{
|
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"Type":"FieldBox",
|
|||
|
|
"Name":"FieldBox12",
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|
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"Left":10.795,
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"Top":2.19604,
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"Width":1.79917,
|
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"Height":0.608542,
|
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|
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"Border":{
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|||
|
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"Styles":"[DrawBottom]"
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},
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"Font":{
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"Name":"宋体",
|
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|
|
"Size":120000,
|
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|
|
"Weight":400,
|
|||
|
|
"Charset":134
|
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|
|
},
|
|||
|
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"DataField":"Name"
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"StaticBox",
|
|||
|
|
"Name":"StaticBox15",
|
|||
|
|
"Left":0.396875,
|
|||
|
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"Top":2.80458,
|
|||
|
|
"Width":14.896,
|
|||
|
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"Height":0.899583,
|
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"Font":{
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|||
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"Name":"宋体",
|
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|
|
"Size":120000,
|
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|
"Weight":400,
|
|||
|
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"Charset":134
|
|||
|
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},
|
|||
|
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"WordWrap":true,
|
|||
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"Text":"为进一步治疗，降低或解除再发严重脑卒中事件，需行。介入手术相关并发症及可能出现的危险如下："
|
|||
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},
|
|||
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|
{
|
|||
|
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"Type":"StaticBox",
|
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"Name":"StaticBox16",
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"Left":0.396875,
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"Top":3.70417,
|
|||
|
|
"Width":15.3194,
|
|||
|
|
"Height":16.9863,
|
|||
|
|
"Font":{
|
|||
|
|
"Name":"宋体",
|
|||
|
|
"Size":120000,
|
|||
|
|
"Weight":400,
|
|||
|
|
"Charset":134
|
|||
|
|
},
|
|||
|
|
"WordWrap":true,
|
|||
|
|
"Text":"1）麻醉意外及药物不良反应（如造影剂过敏、肝肾功能损害等）：\r\n2)术中血管斑块脱落、移位，或脑血管严重痉挛、血管内膜损伤，致急性脑血栓形成或动脉夹层，引起邻近血管闭塞或远端其他部位脑梗死，引起头晕、行走不稳，言语、吞咽、视觉功能障碍、肢体瘫痪，甚至昏迷、植物人状态或死亡等，必要时可能需急诊予以动脉溶栓及支架取栓等抢救治疗措施；\r\n3）球囊、支架、导管等介入器材刺激颅内动脉血管，致血管损伤破裂、颅内大出血，引起言语、吞咽功能障碍、瘫痪，甚至昏迷、植物人状态或死亡等；\r\n4)因球囊或支架刺激颈动脉窦，引起血压下降、心率减慢或休克、心跳、呼吸骤停等反应，加重病情，甚至危及生命；\r\n5）重度狭窄解除后可能继发脑高灌注综合征，导致躁动、癫痫发作、严重脑水肿、脑出血、脑疝等；\r\n6）因患者严重动脉硬化、血管迂曲，以及严重狭窄等病变原因，可能使导管、导丝、支架等不能到达病变部位，致手术不能继续进行，须及时终止介入手术，改用内科药物继续治疗；\r\n7)心跳、呼吸骤停，或发生其他意外，危及生命；\r\n8）股动脉穿刺部位血肿、感染；\r\n9)术中可能发生其他未能预估到的特殊病情变化或急性不良反应，手术医师有权根据实际情况，按照相关医疗原则及有利于患者健康、减轻病情危害性的原则，酌情调整手术治疗方案，并及时告知患者家属；\r\n10）支架植入术后血管再狭窄可能，需术后定期复查及长期服用抗栓、调脂药物治疗，必要时需再次行血管成型支架置入术；\r\n11)手术不成功及其它情况（如血管严重迂曲、痉挛，病人不能耐受，其他脏器功能发生严重不良反应等)，致手术不能继续进行，须及时终止介入手术，改用内科药物继续治疗。注意：若因上述原因导致手术不成功者，患方仍需承担所耗材料及手术相关费用；\r\n12）患者原有基础疾患（如：心、肺、肝、肾等重要脏器疾患）在术中发生合并症，出现相应功能障碍，加重病情等；\r\n13）本次手术仅只能解决部分严重血管病变风险，如患者高龄，身体机能自然退化，其他部位亦有动脉粥样硬化斑块形成等原因，术后亦有可能在其他动脉血管发生狭窄病变，并在其供血区域发生闭塞、梗死可能，需长期控制危险因素、内科药物治疗；\r\n14）以上情况我们将充分考虑，认真准备，针对具体病情积极采取防治措施，尽力防止出现严重并发症，降低手术风险。但因目前医疗发展水平及医疗条件有限，一些病情不能完全靠手术治疗来解决；术中亦可能发生一些非人为因素所能控制的不良情况，引起病情不能\r\n缓解或病情加重，希望患者及其家属能充分理解。\r\n以上情况我们将充分考虑，认真准备，针对具体病情积极采取防治措施，尽力防止出现严重并发症，降低手术风险。但因目前医疗技术发展水平有限，以及患者病情个体差异等情况，有可能在采取了积极防治措施的基础上仍发生不同程度的并发症或手术意外风险，希望患者及其家属能充分理解。"
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"StaticBox",
|
|||
|
|
"Name":"StaticBox17",
|
|||
|
|
"Left":0.396875,
|
|||
|
|
"Top":20.7963,
|
|||
|
|
"Width":15.3194,
|
|||
|
|
"Height":1.79917,
|
|||
|
|
"Font":{
|
|||
|
|
"Name":"宋体",
|
|||
|
|
"Size":120000,
|
|||
|
|
"Weight":400,
|
|||
|
|
"Charset":134
|
|||
|
|
},
|
|||
|
|
"WordWrap":true,
|
|||
|
|
"Text":"医师已对病情及上述情况作了详细介绍和解释，患者（或家属代表)已详细阅读了上述内容，对病情及术中、术后可能出现的问题（危险）均已了解清楚和理解，经慎重考虑，决定"
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"StaticBox",
|
|||
|
|
"Name":"StaticBox20",
|
|||
|
|
"Left":5.79438,
|
|||
|
|
"Top":21.9869,
|
|||
|
|
"Width":3.04271,
|
|||
|
|
"Height":0.47625,
|
|||
|
|
"Font":{
|
|||
|
|
"Name":"宋体",
|
|||
|
|
"Size":120000,
|
|||
|
|
"Weight":400,
|
|||
|
|
"Charset":134
|
|||
|
|
},
|
|||
|
|
"WordWrap":true,
|
|||
|
|
"Text":"做此手术治疗。"
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"FieldBox",
|
|||
|
|
"Name":"FieldBox15",
|
|||
|
|
"Left":3.99521,
|
|||
|
|
"Top":21.9869,
|
|||
|
|
"Width":1.61396,
|
|||
|
|
"Height":0.47625,
|
|||
|
|
"Border":{
|
|||
|
|
"Styles":"[DrawBottom]"
|
|||
|
|
},
|
|||
|
|
"Font":{
|
|||
|
|
"Name":"宋体",
|
|||
|
|
"Size":120000,
|
|||
|
|
"Weight":400,
|
|||
|
|
"Charset":134
|
|||
|
|
},
|
|||
|
|
"DataField":"Agree"
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"StaticBox",
|
|||
|
|
"Name":"StaticBox22",
|
|||
|
|
"Left":0.396875,
|
|||
|
|
"Top":22.86,
|
|||
|
|
"Width":10.6627,
|
|||
|
|
"Height":0.47625,
|
|||
|
|
"Font":{
|
|||
|
|
"Name":"宋体",
|
|||
|
|
"Size":120000,
|
|||
|
|
"Weight":400,
|
|||
|
|
"Charset":134
|
|||
|
|
},
|
|||
|
|
"Text":"如果患者无法签署知情同意书,请其授权的亲属在此签名:"
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"StaticBox",
|
|||
|
|
"Name":"StaticBox23",
|
|||
|
|
"Left":0.343958,
|
|||
|
|
"Top":26.9346,
|
|||
|
|
"Width":2.40771,
|
|||
|
|
"Height":0.899583,
|
|||
|
|
"Font":{
|
|||
|
|
"Name":"宋体",
|
|||
|
|
"Size":120000,
|
|||
|
|
"Weight":400,
|
|||
|
|
"Charset":134
|
|||
|
|
},
|
|||
|
|
"WordWrap":true,
|
|||
|
|
"Text":"患者/患者授权亲属签名"
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"PictureBox",
|
|||
|
|
"Name":"PictureBox1",
|
|||
|
|
"Left":2.80458,
|
|||
|
|
"Top":26.4848,
|
|||
|
|
"Width":2.59292,
|
|||
|
|
"Height":1.79917,
|
|||
|
|
"DataField":"PatientSignature"
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"StaticBox",
|
|||
|
|
"Name":"StaticBox24",
|
|||
|
|
"Left":5.50333,
|
|||
|
|
"Top":27.1463,
|
|||
|
|
"Width":2.19604,
|
|||
|
|
"Height":0.47625,
|
|||
|
|
"Font":{
|
|||
|
|
"Name":"宋体",
|
|||
|
|
"Size":120000,
|
|||
|
|
"Weight":400,
|
|||
|
|
"Charset":134
|
|||
|
|
},
|
|||
|
|
"Text":"与患者关系"
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"FieldBox",
|
|||
|
|
"Name":"FieldBox16",
|
|||
|
|
"Left":7.69938,
|
|||
|
|
"Top":27.0669,
|
|||
|
|
"Width":2.19604,
|
|||
|
|
"Height":0.608542,
|
|||
|
|
"Font":{
|
|||
|
|
"Name":"宋体",
|
|||
|
|
"Size":120000,
|
|||
|
|
"Weight":400,
|
|||
|
|
"Charset":134
|
|||
|
|
},
|
|||
|
|
"DataField":"Relationship"
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"StaticBox",
|
|||
|
|
"Name":"StaticBox25",
|
|||
|
|
"Left":0.396875,
|
|||
|
|
"Top":28.6015,
|
|||
|
|
"Width":14.896,
|
|||
|
|
"Height":1.5875,
|
|||
|
|
"Font":{
|
|||
|
|
"Name":"宋体",
|
|||
|
|
"Size":120000,
|
|||
|
|
"Weight":400,
|
|||
|
|
"Charset":134
|
|||
|
|
},
|
|||
|
|
"WordWrap":true,
|
|||
|
|
"Text":"医护人员陈述：\r\n我已经将患者目前的病情危重、溶栓治疗可能出现的并发症和风险以及医护人员在患者病情危重时进行的救治措施向患者家属或患者的法定监护人、授权委托人详细告知。"
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"PictureBox",
|
|||
|
|
"Name":"PictureBox2",
|
|||
|
|
"Left":3.20146,
|
|||
|
|
"Top":30.136,
|
|||
|
|
"Width":2.59292,
|
|||
|
|
"Height":1.61396,
|
|||
|
|
"DataField":"DoctorSignature"
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"StaticBox",
|
|||
|
|
"Name":"StaticBox26",
|
|||
|
|
"Left":7.77875,
|
|||
|
|
"Top":30.7446,
|
|||
|
|
"Width":1.79917,
|
|||
|
|
"Height":0.396875,
|
|||
|
|
"Font":{
|
|||
|
|
"Name":"宋体",
|
|||
|
|
"Size":120000,
|
|||
|
|
"Weight":400,
|
|||
|
|
"Charset":134
|
|||
|
|
},
|
|||
|
|
"Text":"签名时间"
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"FieldBox",
|
|||
|
|
"Name":"FieldBox17",
|
|||
|
|
"Left":9.60438,
|
|||
|
|
"Top":30.5329,
|
|||
|
|
"Width":5.58271,
|
|||
|
|
"Height":0.820208,
|
|||
|
|
"Font":{
|
|||
|
|
"Name":"宋体",
|
|||
|
|
"Size":120000,
|
|||
|
|
"Weight":400,
|
|||
|
|
"Charset":134
|
|||
|
|
},
|
|||
|
|
"DataField":"DoctorSignatureTime"
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"Line",
|
|||
|
|
"Name":"Line1",
|
|||
|
|
"Left":0.211667,
|
|||
|
|
"Top":1.00542,
|
|||
|
|
"Width":15.584
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"Line",
|
|||
|
|
"Name":"Line2",
|
|||
|
|
"Left":0.211667,
|
|||
|
|
"Top":2.01083,
|
|||
|
|
"Width":15.584
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"Line",
|
|||
|
|
"Name":"Line3",
|
|||
|
|
"Left":0.211667,
|
|||
|
|
"Top":20.7963,
|
|||
|
|
"Width":15.584
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"Line",
|
|||
|
|
"Name":"Line4",
|
|||
|
|
"Left":0.211667,
|
|||
|
|
"Top":28.3898,
|
|||
|
|
"Width":15.584
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"Line",
|
|||
|
|
"Name":"Line5",
|
|||
|
|
"Left":15.7956,
|
|||
|
|
"Top":1.00542,
|
|||
|
|
"Height":30.9827
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"Line",
|
|||
|
|
"Name":"Line6",
|
|||
|
|
"Left":0.211667,
|
|||
|
|
"Top":1.00542,
|
|||
|
|
"Height":30.9827
|
|||
|
|
},
|
|||
|
|
{
|
|||
|
|
"Type":"Line",
|
|||
|
|
"Name":"Line7",
|
|||
|
|
"Left":0.211667,
|
|||
|
|
"Top":31.9881,
|
|||
|
|
"Width":15.584
|
|||
|
|
}
|
|||
|
|
]
|
|||
|
|
}
|
|||
|
|
]
|
|||
|
|
}
|