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					"DBFieldName":"医护签字时间"
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					"DBFieldName":"患者签名时间"
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					"Name":"Name",
					"DBFieldName":"姓名"
				},
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					"Name":"Age",
					"DBFieldName":"年龄"
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					"Name":"Gender",
					"DBFieldName":"性别"
				},
				{
					"Name":"Relationship",
					"DBFieldName":"关系"
				},
				{
					"Name":"Number",
					"DBFieldName":"病历号"
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					"DBFieldName":"医护人员签字"
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					"Name":"PatientSignature",
					"Type":"Binary",
					"DBFieldName":"患者签字"
				},
				{
					"Name":"Agree",
					"DBFieldName":"是否同意"
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		"ColumnTitle":{
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			"Name":"ReportHeader1",
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					"Type":"StaticBox",
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					"Text":"姓名："
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					"Text":"性别："
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					"Text":"医护人员签名"
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					"Text":"签名时间"
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					"TextAlign":"MiddleCenter",
					"Text":"脑出血开颅手术知情同意书"
				},
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					"Top":0.714375,
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					"Text":"病历号："
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					"Type":"FieldBox",
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					"Text":"一、术前诊断:"
				},
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					"Text":"二、拟施行手术及麻醉：\r\n需要在局麻和/或静脉麻醉和/或全麻麻醉下进行微创颅内血肿清除术/侧脑室穿刺引流术手术。"
				},
				{
					"Type":"StaticBox",
					"Name":"StaticBox16",
					"Left":0.396875,
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					"WordWrap":true,
					"Text":"三、实行该手术存在的风险及可能发生的意外和并发症\r\n1.此手术可能发生的风险、并发症和意外:\r\n1)麻醉意外、手术意外导致呼吸心跳骤停危及生命;\r\n2)术中、术后出现脑疝导致中枢性呼吸循环衰竭危及生命;\r\n3)术中大出血、甚至出血无法控制导致失血性休克危及生命;\r\n4)术后预内再出血,需要再次开颅手术;\r\n5)术中出现脑膨出,需行内减压或去骨瓣减压手术;\r\n6)术中发现其他病变需改变术式,亦可能无法进行预期手术;\r\n7)术中因情况特殊而行姑息手术;\r\n8)术后切口愈合不佳,出现脑脊液漏,影响预后或需行手术治行;\r\n9)术后出现多系统感染、应激性溃疡、深静脉血栓、肺栓塞、压疮、脑梗死等并发症加重病情甚至危及生命；\r\n10)术后可能出现偏瘫、失语、吞咽障碍、癫痫、精神障碍、内分泌功能障碍、性功能障碍、长期昏迷甚至植物人状态等,严重影响生存质量,甚至危及生命;\r\n11)术后引发其他隐匿性疾病而危及生命;\r\n12)术后颅骨缺损,需行颅骨修补术;术后出现慢性硬膜下积液或脑积水,需行外引流或分流术13)术后营养不良,需行较长时间培补治疗;术后出现长期昏迷、甚至死亡,需投入大量人力物力，甚至人财两空\r\n14)术后因欠费影响正常医疗活动,责任需自负;\r\n15)其他不可预料的情况。\r\n2.麻醉风险见《麻醉同意书》\r\n3.任何所用药物都可能产生不良反应,包括轻度恶心、皮疹等症状,直至严重的过敏性休克,甚至危及生命。\r\n4.对于患有高血压、心脏病、糖尿病、肝肾功能不全、静脉血栓等疾病,或者有吸烟、酸 酒史的患者,以上这些风险可能会加大,或者在术中或术后出现相关的病情加重或心脑血管意外,甚至死亡。\r\n5.如患者术后不遵医嘱或不配合治疗,可能影响手术效果。\r\n6.其他难以预料的,危及患者生命等意外情况。\r\n四、替代治疗方案告知我们对以上各项均已了解清楚,同意接受手术治疗,愿意承担因此而带来的各种风险。\r\n并同意:\r\n1.手术中发现的情况可能与术前估计有差异,在手术操作中医师可以根据患者的病情征得法定代理人签字同意后,对预定的操作作出调整。\r\n2.授权医师对于操作切除的病变器官、组织或者标本进行处置，包括病理学检查、细胞学检查和医疗废物处理等"
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					},
					"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:"
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					"Type":"StaticBox",
					"Name":"StaticBox23",
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					"WordWrap":true,
					"Text":"患者/患者授权亲属签名"
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					"Name":"PictureBox1",
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					"Text":"与患者关系"
				},
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					"WordWrap":true,
					"Text":"医护人员陈述：\r\n我已经将患者目前的病情危重、血管内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。"
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					"Text":"签名时间"
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					"Type":"FieldBox",
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					"Text":"术前诊断:"
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