带输入框模版

告知书模版   2024-08-03 14:52   103   0  
<div content style="font-size: 14px;">
        <table cellspacing="0" cellpadding="0" border="0" align="left" style="height: 850px;width: 100%;margin-bottom: 10px;margin-top:5px;border-collapse: collapse;border: none;">
            <tr>
                <td style="vertical-align: top">
                    <div style="padding: 0 10px 0 5px;width: 100%;line-height: 2">
                        <div style="display: flex;display: -webkit-flex;margin-left: 10px">
                            <div style="flex: 1;">
                                <div style="display: flex;display: -webkit-flex;">
                                    <div>入院日期:</div>
                                    <span v-if="admission && admission._admissionTime">
                                        <span>{{ admission._admissionTime?.split(' ')?.[0]?.split('-')[0] }}年</span>
                                        <span>{{ admission._admissionTime?.split(' ')?.[0]?.split('-')[1] }}月</span>
                                        <span>{{ admission._admissionTime?.split(' ')?.[0]?.split('-')[2] }}日</span>
                                        <span>{{ admission._admissionTime?.split(' ')?.[1]?.split(':')[0] }}时</span>
                                        <span>{{ admission._admissionTime?.split(' ')?.[1]?.split(':')[1] }}分</span>
                                    </span>
                                    <span v-else><span style="padding-left: 30px">年</span><span style="padding-left: 30px">月</span><span style="padding-left: 30px">日</span><span style="padding-left: 30px">时</span><span style="padding-left: 30px">分</span></span>
                                </div>
                            </div>
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin-left: 10px">
                            <div>入院诊断:</div>
                            <div style="flex: 1;white-space:pre-line;white-space: pre-wrap;">
                                <span v-if="shows">{{ shows['9963000014001'] }}</span>
                            </div>
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin-left: 10px">
                            <div>操作名称:</div>
                            <div style="flex: 1;white-space:pre-line;white-space: pre-wrap;">
                                <span v-if="shows">{{ shows['9963000014002'] }}</span>
                            </div>
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin-left: 10px">
                            <div>操作指征:</div>
                            <div style="flex: 1;white-space:pre-line;white-space: pre-wrap;">
                                <span v-if="shows">{{ shows['9963000014003'] }}</span>
                            </div>
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin-left: 10px">
                            <div style="display: flex;display: -webkit-flex;">
                                <div style="flex: 1; text-align: justify;overflow: hidden;">操作日期:</div>
                            </div>
                            <div style="flex: 1;">
                                <span v-if="shows && shows['9963000014004']">
                                    <div style="display: flex;">
                                        <div>{{ shows?.['9963000014004']?.split(' ')?.[0]?.split('-')[0] }}年</div>
                                        <div style="width: 32px;">{{ shows?.['9963000014004']?.split(' ')?.[0]?.split('-')[1] }}月</div>
                                        <div style="width: 32px;">{{ shows?.['9963000014004']?.split(' ')?.[0]?.split('-')[2] }}日</div>
                                        <div style="width: 32px;">{{ shows?.['9963000014004']?.split(' ')?.[1]?.split(':')[0] }}时</div>
                                        <div style="width: 32px;">{{ shows?.['9963000014004']?.split(' ')?.[1]?.split(':')[1] }}分</div>
                                    </div>
                                </span>
                                <span v-else>&nbsp;&nbsp;年&nbsp;&nbsp;月&nbsp;&nbsp;日&nbsp;&nbsp;时&nbsp;&nbsp;分</span>
                            </div>
                            <div style="display: flex;display: -webkit-flex;">
                                <div style="flex: 1; text-align: justify;overflow: hidden;">麻醉方式:</div>
                            </div>
                            <div style="flex: 1;">
                                <span v-if="shows">{{ shows['9963000014005'] }}</span>
                            </div>
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin: 0 10px;">
                            该操作/诊疗有发生以下情况的危险性:
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin: 0 10px;text-indent: 2em">
                            局麻药物过敏性休克、操作部位的各种感染、操作部位的损伤出血、骨质劈裂、发生其他难以预料的,危及患者生命或致残的意外情况;
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin: 0 10px;text-indent: 2em">
                            除以上情况外另有一个风险:
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin: 0 10px;text-indent: 2em">
                            ①皮肤水疱形成&nbsp;&nbsp;②骨折牵引远端出现缺血、坏死
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin: 0 10px;text-indent: 2em">
                            ③牵引钉道感染&nbsp;&nbsp;④牵引针滑脱
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin: 0 10px;text-indent: 2em">
                            ⑤骨折复位不良&nbsp;&nbsp;⑥骨突出部位出现压疮
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin: 0 10px;text-indent: 2em">
                            ⑦关节僵硬&nbsp;&nbsp;⑧足下垂
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin: 0 10px;text-indent: 2em">
                            ⑨肌肉萎缩&nbsp;&nbsp;⑩长期卧床导致便秘
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin: 20px 10px 0 10px;text-indent: 2em">
                            对以上可能出现的并发症或意外情况我表示理解,如果我患有高血压、心脏病、糖尿病、肝肾功能不全、静脉血栓等疾病或者有吸烟史,以上这些风险可能会加大,或者在操作中或者操作后出现相关的病情加重或心脑血管意外,甚至死亡,我理解操作后如果我的体位不当或者不遵医嘱,可能影响上述治疗效果,同意接受该项操作/诊疗,并愿意承担因此而来的各种风险,并同意积极配合院方治疗。
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin: 20px 10px 20px 10px">
                            <div style="display: flex;display: -webkit-flex;">患者(被授权人)签名:________</div>
                            <div style="display: flex;display: -webkit-flex;margin-left: 5px">与患者本人关系:________</div>
                            <div style="display: flex;display: -webkit-flex;margin-left: 5px">
                                <div>签名时间:</div>
                                <div style="width: 25px"></div>年
                                <div style="width: 25px"></div>月
                                <div style="width: 25px"></div>日
                                <div style="width: 25px"></div>时
                                <div style="width: 25px"></div>分
                            </div>
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin: 0 10px;">
                            医生陈述:
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin: 0 10px;text-indent: 2em">
                            我已告知患者将要进行的操作方式、此次操作后可能发生的并发症和风险、可能存在的其他治疗方法并且解答了患者关于此次操作的相关问题。
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin: 10px 10px 20px 10px">
                            <div style="display: flex;display: -webkit-flex;">医师签名:_____________</div>
                            <div style="display: flex;display: -webkit-flex;margin-left: 100px">上级医师签名:_____________</div>
                        </div>
                        <div style="display: flex;display: -webkit-flex;margin: 10px 10px 0 10px">
                            <div style="display: flex;display: -webkit-flex;">
                                <div>谈话时间:</div>
                                <div style="width: 40px"></div>年
                                <div style="width: 40px"></div>月
                                <div style="width: 40px"></div>日
                                <div style="width: 40px"></div>时
                                <div style="width: 40px"></div>分
                            </div>
                        </div>
                    </div>
                </td>
            </tr>
        </table>
    </div>