483 lines
12 KiB
Plaintext
483 lines
12 KiB
Plaintext
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"Printer":{
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"DetailGrid":{
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"Recordset":{
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"Field":[
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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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"DBFieldName":"患者签名时间"
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},
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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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"Name":"Gender",
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"DBFieldName":"性别"
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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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"Name":"StaticBox2",
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"Text":"姓名："
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"Text":"性别："
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"Name":"宋体",
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"Text":"年龄："
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"Text":"医护人员签名"
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"Text":"签名时间"
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"Type":"FieldBox",
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"Name":"FieldBox3",
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"Left":1.79917,
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"DataField":"Name"
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"Width":1.19063,
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"Font":{
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"Name":"宋体",
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"Charset":134
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"DataField":"Gender"
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"Type":"FieldBox",
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"Name":"FieldBox7",
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"Font":{
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"Name":"宋体",
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"DataField":"Age"
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"Type":"FieldBox",
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"Name":"FieldBox10",
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"Left":4.39208,
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"Font":{
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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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"Text":"脑出血开颅手术知情同意书"
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},
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"Font":{
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"Name":"宋体",
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},
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"Text":"病历号："
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},
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"Type":"FieldBox",
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"Name":"FieldBox11",
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"Left":11.8004,
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"Width":2.80458,
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"Height":0.608542,
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"Font":{
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"Name":"宋体",
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"DataField":"Number"
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"Name":"StaticBox12",
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"Left":0.396875,
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"Top":1.45521,
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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":"一、术前诊断:"
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},
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{
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"Type":"StaticBox",
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"Name":"StaticBox15",
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"Left":0.396875,
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"Top":2.01083,
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"Width":15.0019,
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"Height":1.40229,
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"Font":{
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"Name":"宋体",
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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":"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。"
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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":3.41313,
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"Width":15.3194,
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"Height":14.8696,
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"Font":{
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"Name":"宋体",
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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":"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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},
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"Name":"StaticBox22",
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"Left":0.396875,
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"Top":18.3885,
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},
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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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},
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"Type":"StaticBox",
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"Name":"StaticBox23",
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"Left":0.343958,
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},
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"WordWrap":true,
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"Text":"患者/患者授权亲属签名"
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},
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"Type":"PictureBox",
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"Name":"PictureBox1",
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"Left":2.80458,
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},
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"Text":"与患者关系"
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},
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{
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"Type":"FieldBox",
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"Name":"FieldBox16",
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"Left":7.69938,
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"DataField":"Relationship"
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},
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"WordWrap":true,
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"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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},
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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":"FieldBox17",
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"Left":9.60438,
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},
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"DataField":"DoctorSignatureTime"
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},
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"Text":"术前诊断:"
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}
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]
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}
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]
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} |